BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2970703 · Received February 20, 2013

    Report

    Report Number
    1525712-2013-01294
    Event Type
    Malfunction
    Date Received
    February 20, 2013
    Date of Event
    January 16, 2013
    Report Date
    February 20, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    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

    PROVIDER STATED ALLEGEDLY THAT THE WALKING BEAM WELD IS DISCONNECTED WHERE THE MOTOR CONNECTS TO THE CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    74752 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSI-2

    Patients

    Seq Age Sex Outcome Treatment
    1 52 Other