BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3830976 · Received May 23, 2014

    Report

    Report Number
    1525712-2014-02650
    Event Type
    Malfunction
    Date Received
    May 23, 2014
    Report Date
    April 14, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES THAT THE MOTOR IS MISSING THE MOTOR CAP THAT GOES OVER THE BRAKE PLATE ON A 3GTQ3-CG POWER WHEEL CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    307571 POWERED WHEELCHAIR 890.3860 IOR INVACARE TAYLOR STREET 3GTQ3-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other