BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3069242 · Received April 19, 2013

    Report

    Report Number
    1525712-2013-03095
    Event Type
    Malfunction
    Date Received
    April 19, 2013
    Report Date
    March 25, 2013
    Manufacturer
    UNKNOWN
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES USER SAID THE WHEEL CAME OFF THE RIM. DEALER ALSO STATED USER HAS BEEN RIDING THE CHAIR AROUND JUST ON THE RIM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    170000 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other