BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3800881 · Received May 8, 2014

    Report

    Report Number
    1525712-2014-02352
    Event Type
    Malfunction
    Date Received
    May 8, 2014
    Report Date
    March 31, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UT, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER SET JOYSTICK ON THE TURTLE OF HER TDXSP-MCG POWER WHEEL CHAIR BUT CHAIR ACCELERATED RAPIDLY AND RAN INTO DOOR AND SIDE WALL. END USER INJURED HER RIGHT HAND RING AND PINKY FINGER. SHE SUSTAINED BRUISING AND SWELLING AS A RESULT OF THIS INJURY BUT DID NOT SEEK MEDICAL ATTENTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    277335 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-MCG

    Patients

    Seq Age Sex Outcome Treatment
    1 64 Other