BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3036331 · Received April 4, 2013

    Report

    Report Number
    9615350-2013-00007
    Event Type
    Malfunction
    Date Received
    April 4, 2013
    Report Date
    March 7, 2013
    Manufacturer
    MOTION CONCEPTS
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    LA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATED THAT THE BRACKET THAT ATTACHES A PBE1916 MATRX ELITE BACK TO AN UNKNOWN WHEELCHAIR BROKE WHERE IT ATTACHES TO THE BACK CANES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    138381 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR MOTION CONCEPTS PBE1916

    Patients

    Seq Age Sex Outcome Treatment
    1 Other