FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 2940043 · Received February 1, 2013

Report

Report Number
9616091-2013-00147
Event Type
Malfunction
Date Received
February 1, 2013
Report Date
January 30, 2013
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). NO RMA HAS BEEN INITIATED FOR THIS ISSUE. QUOTE WAS PROVIDED. THE MALFUNCTION HAS NOT BEEN CONFIRMED.

Description of Event or Problem · 1

PROVIDER STATES BEARINGS ARE BAD ON FORK STEM.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
44761 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX 9XDT

Patients

Seq Age Sex Outcome Treatment
1 Other