BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3171290 · Received June 14, 2013

    Report

    Report Number
    3004493922-2013-01273
    Event Type
    Malfunction
    Date Received
    June 14, 2013
    Report Date
    May 20, 2013
    Manufacturer
    INVACARE SUZHOU
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATED THE SEAT POST HAD BROKEN INTO THE SEAT FRAME. STATED THE BOLT WAS ALSO LOOSE. (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    271873 POWERED WHEELCHAIR 890.3860 ITI INVACARE SUZHOU M51P

    Patients

    Seq Age Sex Outcome Treatment
    1 Other