FDA Adverse Event
Malfunction
Summary report: N
POWERED WHEELCHAIR
MDR report key: 3114599
·
Received May 15, 2013
Report
- Report Number
- 9615350-2013-00009
- Event Type
- Malfunction
- Date Received
- May 15, 2013
- Report Date
- April 18, 2013
- Manufacturer
- MOTION CONCEPTS
- Product Code
- ITI
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
PROVIDER STATES HARDWARE WOULDN'T HOLD AT FIRST, THEN IT BROKE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 215237 | POWERED WHEELCHAIR | 890.3860 | ITI | MOTION CONCEPTS | UNKNOWN |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |