FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3031700 · Received April 2, 2013

Report

Report Number
9616091-2013-00547
Event Type
Malfunction
Date Received
April 2, 2013
Report Date
March 6, 2013
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OK, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

(B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. PROVIDER STATES CHUNKS OF THE TIRE ARE WEARING OFF. MDR FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
133735 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX 9XDT

Patients

Seq Age Sex Outcome Treatment
1 Other