FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3083531 · Received April 29, 2013

Report

Report Number
9616091-2013-00708
Event Type
Malfunction
Date Received
April 29, 2013
Report Date
April 2, 2013
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

(B)(4). IT WAS REPORTED BY THE FACILITY STAFF THAT THE TRACER T4 MECHANICAL WHEELCHAIR FOOTPLATE WAS BROKEN. THERE WAS NO INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
184014 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX T424RDA

Patients

Seq Age Sex Outcome Treatment
1 Other