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