BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3133597 · Received May 29, 2013

    Report

    Report Number
    1525712-2013-04194
    Event Type
    Malfunction
    Date Received
    May 29, 2013
    Report Date
    May 2, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    HI, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    PER END USER GOT CHAIR USED TIRES AND THEY ARE GOING FLAT AND THE TREAD ON THE TIRES IS WORN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    235856 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M51TANRD

    Patients

    Seq Age Sex Outcome Treatment
    1 Other