BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3800046 · Received May 8, 2014

    Report

    Report Number
    3004493922-2014-00663
    Event Type
    Malfunction
    Date Received
    May 8, 2014
    Report Date
    March 31, 2014
    Manufacturer
    INVACARE SUZHOU
    Product Code
    ITI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    (B)(4) POWER WHEEL CHAIR JOYSTICK SURGED AND RAN END USER INTO KITCHEN CABINET. END USER STUBBED HIS TOE BUT DID NOT SEEK MEDICAL ATTENTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    279037 POWERED WHEELCHAIR 890.3860 ITI INVACARE SUZHOU M51PRSOLIDB

    Patients

    Seq Age Sex Outcome Treatment
    1 50 Other