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