BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3243370 · Received July 23, 2013

    Report

    Report Number
    1525712-2013-06052
    Event Type
    Malfunction
    Date Received
    July 23, 2013
    Report Date
    July 3, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    LA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER SAID THE CHAIR SURGES AS IF THE BRAKES WERE BEING APPLIED. HE THEN WANTED TO GO OVER THE FAULT LOG, 600,603. AFTER EXPLAINING THE FAULT LOG HE SAID THE CHAIR STOPS AND FLASHES 6.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    344322 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M61

    Patients

    Seq Age Sex Outcome Treatment
    1 Other