BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3013802 · Received March 20, 2013

    Report

    Report Number
    1525712-2013-02125
    Event Type
    Malfunction
    Date Received
    March 20, 2013
    Report Date
    February 20, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES CHAIR HAS NOT ACTED UP FOR THE DEALER. DEALER SAYS THE USER SAYS THE CHAIR INTERMITTENTLY WOULD NOT STOP (3 TIMES). WE ARE REPLACING THE JOYSTICK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    116268 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-MCG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other