BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3233411 · Received July 18, 2013

    Report

    Report Number
    1525712-2013-05910
    Event Type
    Malfunction
    Date Received
    July 18, 2013
    Report Date
    June 27, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    CONSUMER ALLEGES THAT THE POSITIONING STRAP ON HER FATHER'S CHAIR THE BUCKLE HAS COME OFF COMPLETELY. CONSUMER DID STATE SHE BELIEVES THE BELT WAS RUN OVER BUT IS NOT ENTIRELY SURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    334250 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M91

    Patients

    Seq Age Sex Outcome Treatment
    1 Other