FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3790519 · Received May 5, 2014

Report

Report Number
1525712-2014-02286
Event Type
Malfunction
Date Received
May 5, 2014
Date of Event
April 3, 2014
Report Date
April 3, 2014
Manufacturer
INVACARE TAYLOR STREET
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER STATED THAT THE RIGHT SIDE SEAT FRAME ON A (B)(4) WHEELCHAIR BROKE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
269201 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET TA4T

Patients

Seq Age Sex Outcome Treatment
1 Other