BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2981856 · Received February 27, 2013

    Report

    Report Number
    3004493922-2013-00486
    Event Type
    Malfunction
    Date Received
    February 27, 2013
    Report Date
    February 1, 2013
    Manufacturer
    INVACARE SUZHOU
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THE MOTOR IS JERKING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    83406 POWERED WHEELCHAIR 890.3860 ITI INVACARE SUZHOU UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other