BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3150874 · Received June 6, 2013

    Report

    Report Number
    1525712-2013-04426
    Event Type
    Malfunction
    Date Received
    June 6, 2013
    Report Date
    May 10, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER SAID CHAIR WAS TURNED OFF IN SCHOOL CLASS AND CHAIR STARTED MOVING IN A CIRCLE BY ITSELF. COULD NOT TELL ME WHAT WAS ON THE DISPLAY OR WHAT THEY DID TO STOP IT. DEALER WAS NOT THERE WHEN IT HAPPENED AND CAN'T REPRODUCE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    251196 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSI-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other