FDA Adverse Event
Malfunction
Summary report: N
POWERED WHEELCHAIR
MDR report key: 3245211
·
Received July 24, 2013
Report
- Report Number
- 9615350-2013-00016
- Event Type
- Malfunction
- Date Received
- July 24, 2013
- Report Date
- July 5, 2013
- Manufacturer
- MOTION CONCEPTS
- Product Code
- ITI
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- VT, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
IT WAS REPORED THAT A MPB2020 INVACARE MATRIX PB BACK HAD MOUNTING PINS NOT STAYING THREADED IN THE BACK.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 345070 | POWERED WHEELCHAIR | 890.3860 | ITI | MOTION CONCEPTS | MPB2020 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |