FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3252376 · Received July 29, 2013

Report

Report Number
9616091-2013-01346
Event Type
Malfunction
Date Received
July 29, 2013
Report Date
July 11, 2013
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MS, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

THE PROVIDER STATED THE LEFT SIDE FRAME ON A TRSX52FB WHEELCHAIR IS BROKEN AT THE WELD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
352993 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX TRSX51FB

Patients

Seq Age Sex Outcome Treatment
1 Other