BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3157193 · Received June 8, 2013

    Report

    Report Number
    1525712-2013-04474
    Event Type
    Malfunction
    Date Received
    June 8, 2013
    Report Date
    May 13, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES THE PWH CABLE HAS SOME WIRED PULLED OUT OF THE CONNECTOR ON THE STACK SIDE, AND THAT THOSE WIRES ARE TOUCHING AND ARCING AGAINST EACHOTHER. DEALER COULD NOT EXPLAIN HOW THIS HAPPENED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    257968 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSPBASE

    Patients

    Seq Age Sex Outcome Treatment
    1 42 Other