FDA Adverse Event Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3062119 · Received April 16, 2013

Report

Report Number
1531186-2013-01587
Date Received
April 16, 2013
Report Date
March 19, 2013
Manufacturer
ANI [ A&I ] GROUP TAIWAN
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SC, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

(B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. ONE OF THE BACK CANES BROKE PER PROVIDER. MDR FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
163045 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR ANI [ A&I ] GROUP TAIWAN IN88AHANFR

Patients

Seq Age Sex Outcome Treatment
1 Other