FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3183347 · Received June 21, 2013

Report

Report Number
9616091-2013-01057
Event Type
Malfunction
Date Received
June 21, 2013
Report Date
May 28, 2013
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER THE FORK IS BENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
283153 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX T4

Patients

Seq Age Sex Outcome Treatment
1 Other