BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3222417 · Received July 12, 2013

    Report

    Report Number
    1525712-2013-05637
    Event Type
    Malfunction
    Date Received
    July 12, 2013
    Report Date
    June 20, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THE MOTOR ON A TDX5-PS POWER CHAIR IS DRAGGING AND IS NOISY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    322214 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDX5-PS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other