FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3081690 · Received April 29, 2013

Report

Report Number
1525712-2013-03314
Event Type
Malfunction
Date Received
April 29, 2013
Report Date
April 3, 2013
Manufacturer
UNKNOWN
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NJ, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

(B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED.CONSUMER ALLEGES THE COVED SPACER BROKE IN HALF.MDR FILED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
185623 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR UNKNOWN UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other