BEUDAMED
    FDA Adverse Event Summary report: N

    WHEELCHAIR COMPONENTS

    MDR report key: 3821669 · Received May 20, 2014

    Report

    Report Number
    1531186-2014-01851
    Date Received
    May 20, 2014
    Date of Event
    April 7, 2014
    Report Date
    April 7, 2014
    Manufacturer
    JUMAO MEDICAL EQUIPMENT
    Product Code
    KNN
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATED BROKE AT WELD BY SWING AWAY AT THE PINS THE RIGHT UNIT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    300603 WHEELCHAIR COMPONENTS 890.3920 KNN JUMAO MEDICAL EQUIPMENT T93HA_PTO_37801

    Patients

    Seq Age Sex Outcome Treatment
    1 Other