BEUDAMED
    FDA Adverse Event Summary report: N

    WHEELCHAIR COMPONENTS

    MDR report key: 3746790 · Received April 11, 2014

    Report

    Report Number
    1531186-2014-01322
    Date Received
    April 11, 2014
    Date of Event
    March 12, 2014
    Report Date
    March 13, 2014
    Manufacturer
    POPULAR PLASTICS
    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

    DEALER STATED THAT THE LEFT SPACER ON THE (B)(4) LEG REST IS BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    220794 WHEELCHAIR COMPONENTS 890.3920 KNN POPULAR PLASTICS T94HE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other