BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3872227 · Received June 13, 2014

    Report

    Report Number
    1525712-2014-02957
    Event Type
    Malfunction
    Date Received
    June 13, 2014
    Date of Event
    May 2, 2014
    Report Date
    May 16, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THAT THE LEFT CROSSBRACE BROKE AT THE CENTER SCREW.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    349936 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET PATRIOT

    Patients

    Seq Age Sex Outcome Treatment
    1 76 Other