BEUDAMED
    FDA Adverse Event Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3833308 · Received May 27, 2014

    Report

    Report Number
    1525712-2014-02642
    Date Received
    May 27, 2014
    Date of Event
    March 29, 2014
    Report Date
    March 31, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    END USER RAN CHAIR INTO THE WALL. HER FEET WERE NOT ON THE FOOTREST AND END USERS LEFT BACK LEG GOT CAUGHT BETWEEN THE FOOTPLATE AND THE WALL. END USER RECEIVED STITCHES FOR THE WOUND. END USER WAS ON A TDXSP-MCG POWER WHEEL CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    310936 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-MCG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other