FDA Adverse Event
Malfunction
Summary report: N
MECHANICAL (MANUAL) WHEELCHAIR
MDR report key: 2930667
·
Received January 28, 2013
Report
- Report Number
- 9616091-2013-00126
- Event Type
- Malfunction
- Date Received
- January 28, 2013
- Report Date
- January 25, 2013
- Manufacturer
- INVAMEX
- Product Code
- IOR
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
A FACILITY HAS REPORTED TO THIS DEALER THAT THE FOOTPLATE IS BREAKING OFF THE FRONT RIGGINGS. DEVICE HAS SINCE BEEN REPLACED. THE FACILITY HAD USED THE MANUAL WHEELCHAIR FOR APPROXIMATELY 6 TO 12 MONTHS. NO INJURY.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 37258 | MECHANICAL (MANUAL) WHEELCHAIR | 890.3850 | IOR | INVAMEX | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |