FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3830988 · Received May 23, 2014

Report

Report Number
1525712-2014-02651
Event Type
Malfunction
Date Received
May 23, 2014
Report Date
April 14, 2014
Manufacturer
INVACARE TAYLOR STREET
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

THE DEALER ALLEGES THE CHAIR IS GOING INTO DRIVE LOCKOUT INTERMITTENTLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
307226 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

Patients

Seq Age Sex Outcome Treatment
1 Other