FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3230695 · Received July 16, 2013

Report

Report Number
9616091-2013-01234
Event Type
Malfunction
Date Received
July 16, 2013
Report Date
June 25, 2013
Manufacturer
INVAMEX
Product Code
IOR
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 REPORTS THE WELD BROKE ON THE LEG REST.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
328082 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX TRSX5RC

Patients

Seq Age Sex Outcome Treatment
1 Other