BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3112812 · Received May 14, 2013

    Report

    Report Number
    1525712-2013-03805
    Event Type
    Malfunction
    Date Received
    May 14, 2013
    Report Date
    April 18, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    CONSUMER ALLEGES THAT ON THE LEFT SIDE THE BAR THAT IS INSIDE OF THE ARM DOES NOT GO ALL THE WAY TO THE END SO IT CAUSING THE PART WITHOUT A ROD TO CRACK AND BEND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    213235 POWERED WHEELCHAIR 890.3860 ITI UNKNOWN M51

    Patients

    Seq Age Sex Outcome Treatment
    1 Other