BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3830332 · Received May 23, 2014

    Report

    Report Number
    1525712-2014-02658
    Event Type
    Malfunction
    Date Received
    May 23, 2014
    Date of Event
    April 12, 2014
    Report Date
    April 14, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IOR
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THE CUSTOMER WAS COMING OFF OF THE SIDEWALK ONTO THE STREET WHEN THE BASE FRAME CRACKED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    307734 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET CT7A

    Patients

    Seq Age Sex Outcome Treatment
    1 32 Other