BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3241801 · Received July 22, 2013

    Report

    Report Number
    1525712-2013-06017
    Event Type
    Malfunction
    Date Received
    July 22, 2013
    Report Date
    July 2, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    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

    PROVIDER STATES THE END USER WAS MEETING WITH PROVIDER TO LOOK AT NEW CHAIRS, WHEN END USER STATED THE UNIT OCCASIONALLY STALLS OUT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    340994 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET 3GARBASE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other