BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3260102 · Received August 1, 2013

    Report

    Report Number
    1525712-2013-06440
    Event Type
    Malfunction
    Date Received
    August 1, 2013
    Report Date
    July 18, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THE PATIENT HEARD A POP FROM THE 2GSTAR-TS POWERED WHEELCHAIR CHARGER. THE CHARGER THEN REPORTEDLY BURST INTO FLAMES. NO PATIENT INJURIES WERE REPORTED AS A RESULT OF THIS EVENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    360979 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET 2GSTAR-TS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other