FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 2993433 · Received March 7, 2013

Report

Report Number
1525712-2013-01747
Event Type
Malfunction
Date Received
March 7, 2013
Report Date
February 11, 2013
Manufacturer
INVACARE TAYLOR STREET
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NE, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

(B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. PER DEALER THE UNIT IS BROKE AT THE WELD. MDR FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
97846 POWERED WHEELCHAIR 890.3860 IOR INVACARE TAYLOR STREET TDXSP

Patients

Seq Age Sex Outcome Treatment
1 Other