BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3022075 · Received March 26, 2013

    Report

    Report Number
    1525712-2013-02309
    Event Type
    Malfunction
    Date Received
    March 26, 2013
    Report Date
    February 26, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES UNIT HAS COUPLE OF DENTS IN IT. SOUNDS LIKE METAL AND UNIT SMOKED WHEN PLUGGED IN. PROVIDER ADVISED THAT THE LEG AT THE BOTTOM OF THE CHARGER HAS A SCREW MISSING. THE HOLD FOR THE SCREW IS BENT PRETTY BADLY. THE PROVIDER THINKS THE SCREW MAY HAVE SHEERED OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    123417 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 65 Other