BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3771616 · Received April 24, 2014

    Report

    Report Number
    1525712-2014-02085
    Event Type
    Malfunction
    Date Received
    April 24, 2014
    Report Date
    March 25, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED A CONNECTOR WITHIN THE POWERED WHEELCHAIR ELECTRICAL SYSTEM WAS DAMAGED WHEN THE END USER BACKED INTO AN OBJECT. THE DAMAGED CONNECTOR RESULTED IN ARCING BETWEEN AND MELTING OF WIRES WITHIN THE SYSTEM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    249909 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-MCG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other