FDA Adverse Event Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3033897 · Received April 3, 2013

Report

Report Number
1531186-2013-01381
Date Received
April 3, 2013
Report Date
March 6, 2013
Manufacturer
ANI [ A&I ] GROUP TAIWAN
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES THERE IS A PIECE OF PLASTIC THAT IS ON THE CROSSBRACE HAS BROKE, NOT SURE HOW.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
137172 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR ANI [ A&I ] GROUP TAIWAN IN08AHANFRFF

Patients

Seq Age Sex Outcome Treatment
1 Other