FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3233035 · Received July 18, 2013

Report

Report Number
1525712-2013-05870
Event Type
Malfunction
Date Received
July 18, 2013
Report Date
June 26, 2013
Manufacturer
INVACARE TAYLOR STREET
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

THE END USERS STATES THE CHAIR STOPS AND THE LEFT MOTOR IS MISSING SOME KIND OF PIN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
334550 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP

Patients

Seq Age Sex Outcome Treatment
1 Other