BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3133466 · Received May 29, 2013

    Report

    Report Number
    1525712-2013-04212
    Event Type
    Malfunction
    Date Received
    May 29, 2013
    Report Date
    April 30, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    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

    THE DEALER REPORTED THAT THE RIGHT MOTOR WAS NOT WORKING. THIS ISSUE COULD CAUSE THE CHAIR TO HAVE ERRATIC/UNNTENDED MOVEMENT WHICH COULD CAUSE INJURY TO THE USER

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    234465 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M71

    Patients

    Seq Age Sex Outcome Treatment
    1 Other