FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3171689 · Received June 15, 2013

Report

Report Number
1525712-2013-04714
Event Type
Malfunction
Date Received
June 15, 2013
Report Date
May 20, 2013
Manufacturer
INVACARE TAYLOR STREET
Product Code
IOR
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

PROVIDER ALLEGED BROKEN AT THE UPPER HOLE FOR SCREW.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
272484 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET PROX4S

Patients

Seq Age Sex Outcome Treatment
1 Other