FDA Adverse Event
Malfunction
Summary report: N
POWERED WHEELCHAIR
MDR report key: 3800047
·
Received May 8, 2014
Report
- Report Number
- 3004493922-2014-00665
- Event Type
- Malfunction
- Date Received
- May 8, 2014
- Report Date
- April 1, 2014
- Manufacturer
- INVACARE SUZHOU
- Product Code
- ITI
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- WA, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
LEFT MOTOR JERKS WHEN IN REVERSE ON A M51PRSOLIDR POWER WHEEL CHAIR.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 279435 | POWERED WHEELCHAIR | 890.3860 | ITI | INVACARE SUZHOU | M51PRSOLIDR |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |