BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3233133 · Received July 18, 2013

    Report

    Report Number
    1531186-2013-03225
    Date Received
    July 18, 2013
    Report Date
    June 27, 2013
    Manufacturer
    KENSTONE METAL
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER PROVIDER PART OF THE WHEEL LOCK THAT GRIPS THE REAR TIRE BROKE OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    333553 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR KENSTONE METAL TRHD22FR

    Patients

    Seq Age Sex Outcome Treatment
    1 Other