FDA Adverse Event
Malfunction
Summary report: N
POWERED WHEELCHAIR
MDR report key: 3243514
·
Received July 23, 2013
Report
- Report Number
- 1525712-2013-06067
- 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
- IN, US
- Reporter Occupation
- PHYSICIST
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT ONE OF THE BOLTS ON A TDXSR-CG POWERED WHEELCHAIR STRIPPED OUT THE CENTER SEAT FRAME.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 342295 | POWERED WHEELCHAIR | 890.3860 | ITI | INVACARE TAYLOR STREET | TDXSR-CG |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |