BEUDAMED
    FDA Adverse Event Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3183140 · Received June 21, 2013

    Report

    Report Number
    1525712-2013-04910
    Date Received
    June 21, 2013
    Report Date
    May 28, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER PROVIDER USER RAN OFF THE ROAD AND TIPPED OVER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    282703 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET 3GRX-TS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other