BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3821780 · Received May 20, 2014

    Report

    Report Number
    3004493922-2014-00756
    Event Type
    Malfunction
    Date Received
    May 20, 2014
    Date of Event
    April 5, 2014
    Report Date
    April 9, 2014
    Manufacturer
    INVACARE SUZHOU
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CONSUMER ALLEGES THAT CHAIR INTERMITTENTLY WILL NOT MOVE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    298909 POWERED WHEELCHAIR 890.3860 ITI INVACARE SUZHOU M41RSOLIDB

    Patients

    Seq Age Sex Outcome Treatment
    1 57 Other