BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3630966 · Received February 17, 2014

    Report

    Report Number
    1525712-2014-00743
    Event Type
    Malfunction
    Date Received
    February 17, 2014
    Report Date
    January 29, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Removal / Correction Number
    Z-2270-2013
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE ATTACHING HARDWARE ON A POWERED WHEELCHAIR RIGGINGS FELL OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    100067 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other