BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3350967 · Received September 16, 2013

    Report

    Report Number
    1525712-2013-07839
    Event Type
    Malfunction
    Date Received
    September 16, 2013
    Report Date
    September 9, 2013
    Manufacturer
    UNKNOWN
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE CROSSBRACE ON A 9XT MANUAL WHEELCHAIR BROKE AT THE BOLT WHERE THE CHAIR FOLDS UP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    464797 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR UNKNOWN 9XT

    Patients

    Seq Age Sex Outcome Treatment
    1 Other