BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3801660 · Received May 9, 2014

    Report

    Report Number
    1525712-2014-02374
    Event Type
    Malfunction
    Date Received
    May 9, 2014
    Report Date
    March 31, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    EGG SWITCH DAMAGED AND MONO PORT PLUG IS BENT ON A FDX-CG POWER WHEEL CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    280900 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET FDX-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other