FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3230594 · Received July 16, 2013

Report

Report Number
3004493922-2013-01513
Event Type
Malfunction
Date Received
July 16, 2013
Report Date
June 26, 2013
Manufacturer
INVACARE SUZHOU
Product Code
ITI
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

IT WAS REPORTED THAT THE MOTOR GEARBOX OF A M51 POWER WHEELCHAIR WAS LEAKING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
328061 POWERED WHEELCHAIR 890.3860 ITI INVACARE SUZHOU M51PSR20B

Patients

Seq Age Sex Outcome Treatment
1 Other