FDA Adverse Event Malfunction Summary report: N

MECHANICAL CHAIR/TRANSPORT CHAIR

MDR report key: 3852848 · Received June 6, 2014

Report

Report Number
1834066-2014-00007
Event Type
Malfunction
Date Received
June 6, 2014
Report Date
April 18, 2014
Manufacturer
CHAMPION MANUFACTURING
Product Code
INM
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
RI, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

CUSTOMER STATES THE FORKS ARE BENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
330964 MECHANICAL CHAIR/TRANSPORT CHAIR 890.3100 INM CHAMPION MANUFACTURING HTR5500

Patients

Seq Age Sex Outcome Treatment
1 Other