BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2990553 · Received March 5, 2013

    Report

    Report Number
    1525712-2013-01633
    Event Type
    Malfunction
    Date Received
    March 5, 2013
    Report Date
    February 6, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE DEALER REPORTED THAT THE CHAIR DROVE TO THE LEFT ON ITS OWN AND DISPLAYED AND UNKNOWN ERROR CODE FOR A MOTOR ISSUE. THE DEALER PUSHED THE CHAIR WHILE IT WAS OFF AND IT WAS DIFFICULT TO MOVE. THE DEALER ELEVATED THE SEAT, PUT THE SEAT DOWN AND THE CHAIR THEN SEEMED TO FUNCTION AS EXPECTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    92906 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other