BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL CHAIR/TRANSPORT CHAIR

    MDR report key: 3024210 · Received March 27, 2013

    Report

    Report Number
    1525712-2013-02354
    Event Type
    Malfunction
    Date Received
    March 27, 2013
    Report Date
    February 26, 2013
    Manufacturer
    UNKNOWN
    Product Code
    INM
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER END USER'S SON, (B)(6) WAS BEING LIFTED OUT OF HER WHEELCHAIR AND THE STRAPS ON THE RIGHT SIDE OF THE SLING BROKE AND SHE FELL TO THE FLOOR. SHE IS AT A FACILITY AND HE IS NOT SURE IF THE LIFT WAS AN INVACARE LIFT, NOR DOES HE HAVE A S/N. HE SAID HE TOOK A PICTURE OF THE SLING SHOWING THE STRAPS BROKEN. HE UNDERSTANDS IT IS AN INVACARE SLING. THE FACILITY THAT SHE IS AT IS CALLED (B)(6). PER (B)(6), SHE GOT XRAYS DONE AND HE JUST GOT THE BILL FOR (B)(6) WHICH THE FACILITY WILL NOT PAY SO HE IS LOOKING FOR US TO PAY. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    126917 MECHANICAL CHAIR/TRANSPORT CHAIR 890.3100 INM UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 82 Other