BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3771640 · Received April 24, 2014

    Report

    Report Number
    1525712-2014-02092
    Event Type
    Malfunction
    Date Received
    April 24, 2014
    Date of Event
    March 18, 2014
    Report Date
    March 24, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CONSUMER ALLEGES THAT THE SHE WAS PULLING UP TO HER CABINET TO DO DISHES AND THE CHAIR DID NOT STOP AFTER SHE LET GO ON THE JOYSTICK AND SHE RAN INTO THE CABINET.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    249916 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M91

    Patients

    Seq Age Sex Outcome Treatment
    1 62 Other