FDA Adverse Event
Malfunction
Summary report: N
POWERED WHEELCHAIR
MDR report key: 3024237
·
Received March 27, 2013
Report
- Report Number
- 9615350-2013-00006
- Event Type
- Malfunction
- Date Received
- March 27, 2013
- Report Date
- February 28, 2013
- Manufacturer
- MOTION CONCEPTS
- Product Code
- ITI
- 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
DEALER STATED THAT THE BACK SHELL WAS CRACKED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 126051 | POWERED WHEELCHAIR | 890.3860 | ITI | MOTION CONCEPTS | EDB1518 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |