FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3110134 · Received May 13, 2013

Report

Report Number
3004493922-2013-01049
Event Type
Malfunction
Date Received
May 13, 2013
Report Date
April 17, 2013
Manufacturer
INVACARE SUZHOU
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

END USER STATES CHAIR IS NOT STOPPING RIGHT AWAY. (P/N 1163475)

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
210977 POWERED WHEELCHAIR 890.3860 ITI INVACARE SUZHOU M51PSEMIRED

Patients

Seq Age Sex Outcome Treatment
1 Other