BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3022103 · Received March 26, 2013

    Report

    Report Number
    1525712-2013-02303
    Event Type
    Malfunction
    Date Received
    March 26, 2013
    Report Date
    February 27, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    TILT NOT WORKING. TECH FOUND TWO BAD SPLICES IN TILT WIRING HARNESS AND WIRING JUST PULLED OUT OF BUTT JOINT. USER STATES THAT HE SAW A SPARK COME OUT THE FRONT END OF THE JOYSTICK. DUST CAPS IN REAR FORKS ARE MISSING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    124696 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other