FDA Adverse Event Summary report: N

POWERED WHEELCHAIR

MDR report key: 3123216 · Received May 21, 2013

Report

Report Number
1531186-2013-02200
Date Received
May 21, 2013
Report Date
April 26, 2013
Manufacturer
JUMAO MEDICAL EQUIPMENT
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NV, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER STATING ONE OF THE REAR WHEELS SPLIT - WANTS TO RETURN CHAIR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
224273 POWERED WHEELCHAIR 890.3860 ITI JUMAO MEDICAL EQUIPMENT V20RFR

Patients

Seq Age Sex Outcome Treatment
1 Other