BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3821833 · Received May 20, 2014

    Report

    Report Number
    1525712-2014-02543
    Event Type
    Malfunction
    Date Received
    May 20, 2014
    Report Date
    April 8, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER STATED THAT THEIR TDXSP-CG POWER CHAIR WAS UNCONTROLLABLE, CHAIR HIT A CEMENT WALL AT SCHOOL. NO INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    300264 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 20 Other