BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3112811 · Received May 14, 2013

    Report

    Report Number
    1525712-2013-03803
    Event Type
    Malfunction
    Date Received
    May 14, 2013
    Report Date
    April 18, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KS, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CONSUMER ALLEGES THAT HIS MOTORS WENT BAD AND OIL LEAKED ON TO HIS CARPET.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    212438 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSI

    Patients

    Seq Age Sex Outcome Treatment
    1 75 Other