BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 2932011 · Received January 28, 2013

    Report

    Report Number
    1525712-2013-00660
    Event Type
    Malfunction
    Date Received
    January 28, 2013
    Date of Event
    December 17, 2012
    Report Date
    January 28, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER DEALER THE FRAME IS BROKEN ON WELD ON THE LEFT SIDE OF THE MANUAL WHEELCHAIR. NO INJURY. REPLACED UNDER WARRANTY. PLEASE NOTE ANY FURTHER INFORMATION OR SAMPLE ANALYSIS WILL BE PROVIDED IN A SUPPLEMENTAL REPORT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    38183 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET XTRA

    Patients

    Seq Age Sex Outcome Treatment
    1 Other