FDA Adverse Event
Malfunction
Summary report: N
POWERED WHEELCHAIR
MDR report key: 3253109
·
Received July 29, 2013
Report
- Report Number
- 9616091-2013-01348
- Event Type
- Malfunction
- Date Received
- July 29, 2013
- Report Date
- July 12, 2013
- Manufacturer
- INVAMEX
- Product Code
- ITI
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OK, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT A P9000XDT1818 POWERED WHEELCHAIR HAD A BROKEN LOWER WELD AT THE CASTER JOURNAL.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 352123 | POWERED WHEELCHAIR | 890.3860 | ITI | INVAMEX | P9000XDT1818 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |