BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3160595 · Received June 10, 2013

    Report

    Report Number
    1525712-2013-04507
    Event Type
    Malfunction
    Date Received
    June 10, 2013
    Report Date
    May 13, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE PROVIDER STATED THE CHAIR TURNS OFF AFTER 15-20 MINUTES. PROVIDER IS UNAWARE IF THERE ARE ANY LIGHTS ON OR FLASHING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    260016 POWERED WHEELCHAIR 890.3860 ITI UNKNOWN M51MPURD

    Patients

    Seq Age Sex Outcome Treatment
    1 Other