BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 2991873 · Received March 6, 2013

    Report

    Report Number
    1525712-2013-01707
    Event Type
    Malfunction
    Date Received
    March 6, 2013
    Report Date
    February 8, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES THE AXLE TUBES BECAME FROZEN IN THE AXLES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    95419 POWERED WHEELCHAIR 890.3860 ITI UNKNOWN A6-S

    Patients

    Seq Age Sex Outcome Treatment
    1 Other