BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2990574 · Received March 5, 2013

    Report

    Report Number
    1525712-2013-01632
    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
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    (B)(6) STATED THAT THEY HAVE BEEN HAVING ISSUES WITH THEIR MOTHER'S CHAIR SINCE THEY HAD GOTTEN IT BACK IN (B)(6). AT FIRST THE CHAIR WASN'T DRIVING PROPERLY AND THEN THE WHEEL HAD FALLEN OFF WHILE SHE WAS IN THE CHAIR. THEY CONTACTED LIFECARE SOLUTIONS AND SAID THERE WASN'T ANYTHING WRONG THEN. ROADRUNNER HAS COME OUT AND REPAIRED/REPLACED A FEW PARTS BUT DEALER REFUSED TO PROGRAM JOYSTICK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    92939 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M61

    Patients

    Seq Age Sex Outcome Treatment
    1 54 Other