BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3180983 · Received June 20, 2013

    Report

    Report Number
    1525712-2013-04869
    Event Type
    Malfunction
    Date Received
    June 20, 2013
    Report Date
    May 24, 2013
    Manufacturer
    UNKNOWN
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MS, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    THE END USER STATED HIS CHAIR HAS STOPPED AND WHEN HE TRIES TO MOVE IT, IT BEGINS TO MAKE A WHINNING NOISE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    280509 POWERED WHEELCHAIR 890.3860 ITI UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other