FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3143458 · Received June 3, 2013

Report

Report Number
1525712-2013-04294
Event Type
Malfunction
Date Received
June 3, 2013
Report Date
April 24, 2013
Manufacturer
INVACARE TAYLOR STREET
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). COMPLAINT WAS NOT GIVEN TO REGULATORY AFFAIRS FOR PROCESSING UNTIL (B)(4) 2013.

Description of Event or Problem · 1

PROVIDER STATES CALF PADS ON A SOLARA3G MANUAL TILT IN SPACE WHEELCHAIR ARE STRIPPING OFF THE HARDWARE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
244306 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET SOLARA3G

Patients

Seq Age Sex Outcome Treatment
1 Other