FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3090773 · Received May 2, 2013

Report

Report Number
9616091-2013-00740
Event Type
Malfunction
Date Received
May 2, 2013
Report Date
April 8, 2013
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

POTENTIAL FOR INJURY ASSOCIATED WITH THE BROKEN BACK CANE ON A 9XT MANUAL WHEEL CHAIR. THIS EVENT COULD CAUSE POSSIBLE PRODUCT INSTABILITY AND THE POTENTIAL FOR THE CHAIR TO NOT MAINTAIN ITS INTENDED WEIGHT-BEARING STATUS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
193019 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX 9XT

Patients

Seq Age Sex Outcome Treatment
1 Other