BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3033999 · Received April 3, 2013

    Report

    Report Number
    1525712-2013-02561
    Event Type
    Malfunction
    Date Received
    April 3, 2013
    Report Date
    March 7, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CONSUMER STATES THAT HE HAS A PROBLEM WITH A BROKEN WELD ON HIS CHAIR. ALSO IS HAVING A PROBLEM WITH HIS REPAIR COMPANY NOT GETTING BACK TO HIM. STATES HE WANTED TO REPORT THIS PROBLEM TO US. ALSO FEELS LIKE HE IS HAVING PROBLEMS WITH HIS JOYSTICK OR CONTROLLER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    137242 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-MCG-GT

    Patients

    Seq Age Sex Outcome Treatment
    1 Other