BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3790686 · Received May 5, 2014

    Report

    Report Number
    1525712-2014-02301
    Event Type
    Malfunction
    Date Received
    May 5, 2014
    Report Date
    March 29, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USERS STATED THAT THEIR BACK UP CHAIR, A TDX5-PS POWER CHAIR, WILL ROLL BACKWARDS WHEN ON AND INCLINE WITH THE BRAKES ENGAGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    269451 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDX5-PS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other