BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3181891 · Received June 21, 2013

    Report

    Report Number
    1525712-2013-04891
    Event Type
    Malfunction
    Date Received
    June 21, 2013
    Report Date
    May 24, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    ID, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES CONTROLLER FAULT ON JOYSTICK.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    282069 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M71SCTRSTR

    Patients

    Seq Age Sex Outcome Treatment
    1 Other