FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3163451 · Received June 11, 2013

Report

Report Number
3004493922-2013-01243
Event Type
Malfunction
Date Received
June 11, 2013
Report Date
May 14, 2013
Manufacturer
INVACARE SUZHOU
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER STATES RIGHT MOTOR GEARBOX IS BINDING UP, WILL NOT DISENGAGE FOR FREEWHEEL, WILL NOT DRIVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
264268 POWERED WHEELCHAIR 890.3860 ITI INVACARE SUZHOU M51PRED20GV

Patients

Seq Age Sex Outcome Treatment
1 Other