FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3243614 · Received July 23, 2013

Report

Report Number
1525712-2013-06075
Event Type
Malfunction
Date Received
July 23, 2013
Report Date
July 5, 2013
Manufacturer
UNKNOWN
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

THE END USER STATED THE CHAIR MAKES SUDDEN STOPS AND SPEEDS UP SUDDENLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
343134 POWERED WHEELCHAIR 890.3860 ITI UNKNOWN M51

Patients

Seq Age Sex Outcome Treatment
1 Other