BEUDAMED
    FDA Adverse Event Summary report: N

    WHEELCHAIR COMPONENTS

    MDR report key: 3741023 · Received April 11, 2014

    Report

    Report Number
    1531186-2014-01278
    Date Received
    April 11, 2014
    Report Date
    March 11, 2014
    Manufacturer
    MAXHEALTH CORP.
    Product Code
    KNN
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER PROVIDER THE FOOT REST IS BROKE AT THE WELD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    224346 WHEELCHAIR COMPONENTS 890.3920 KNN MAXHEALTH CORP. RP176013

    Patients

    Seq Age Sex Outcome Treatment
    1 Other