FDA Adverse Event
Malfunction
Summary report: N
MECHANICAL (MANUAL) WHEELCHAIR
MDR report key: 3062278
·
Received April 16, 2013
Report
- Report Number
- 9616091-2013-00640
- Event Type
- Malfunction
- Date Received
- April 16, 2013
- Report Date
- March 20, 2013
- Manufacturer
- INVAMEX
- Product Code
- IOR
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NE, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
POTENTIAL FOR INJURY ASSOCIATED WITH A T4X22RDA MANUAL WHEELCHAIR WITH A FRAME THAT IS BROKEN AT A WELD. THIS EVENT CAN CAUSE THE CHAIR TO BECOME UNSTABLE AND POSSIBLY COLLAPSE, INJURING THE USER.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 162936 | MECHANICAL (MANUAL) WHEELCHAIR | 890.3850 | IOR | INVAMEX | T4X24RDA |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |