BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3013899 · Received March 20, 2013

    Report

    Report Number
    1525712-2013-02140
    Event Type
    Malfunction
    Date Received
    March 20, 2013
    Report Date
    February 22, 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

    DEALER STATES HAS NOT ACTED UP FOR DEALER. DEALER SAYS THE USER SAYS THE CHAIR STOPS. THE DEALER SAYS THE USER SAYS THE DISPLAY STAYS ON, BUT HAS NO OTHER INFORMATION AS TO IF IT SHOWS WHY THE CHAIR STOPPED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    115533 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET 3GTQ3-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other