BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3211878 · Received July 8, 2013

    Report

    Report Number
    1525712-2013-05442
    Event Type
    Malfunction
    Date Received
    July 8, 2013
    Date of Event
    June 12, 2013
    Report Date
    June 13, 2013
    Manufacturer
    UNKNOWN
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER STATES BOTH FRONT CASTERS BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    309234 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR UNKNOWN TRSX5

    Patients

    Seq Age Sex Outcome Treatment
    1 58 Other