BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3821575 · Received May 20, 2014

    Report

    Report Number
    1525712-2014-02506
    Event Type
    Malfunction
    Date Received
    May 20, 2014
    Report Date
    September 16, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES WELD BROKE ON ARM TUBE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    299901 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M91-TS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other