BEUDAMED
    FDA Adverse Event Summary report: N

    WHEELCHAIR ACCESSORY

    MDR report key: 3200315 · Received July 1, 2013

    Report

    Report Number
    1531186-2013-02859
    Date Received
    July 1, 2013
    Report Date
    June 4, 2013
    Manufacturer
    UNKNOWN
    Product Code
    INE
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE DEALER IS REPORTING THAT THE POLE IS BENT ON THE (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    299674 WHEELCHAIR ACCESSORY 890.3910 INE UNKNOWN 7740P

    Patients

    Seq Age Sex Outcome Treatment
    1 Other