FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3071972 · Received April 22, 2013

Report

Report Number
1525712-2013-03169
Event Type
Malfunction
Date Received
April 22, 2013
Report Date
March 27, 2013
Manufacturer
INVACARE TAYLOR STREET
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES CHAIR SLOWS DOWN INTERMITTENTLY AND BLINKS SLOW LIGHT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
173021 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

Patients

Seq Age Sex Outcome Treatment
1 Other