FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3212027 · Received July 8, 2013

Report

Report Number
9616091-2013-01162
Event Type
Malfunction
Date Received
July 8, 2013
Report Date
June 14, 2013
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NE, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER STATES CROSSBRACE BROKE WHERE A BOLT GOES THROUGH IT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
309413 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX 9XT

Patients

Seq Age Sex Outcome Treatment
1 Other