FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3875319 · Received June 16, 2014

Report

Report Number
1525712-2014-02958
Event Type
Malfunction
Date Received
June 16, 2014
Report Date
May 19, 2014
Manufacturer
INVACARE TAYLOR STREET
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

THE 9-PIN PORT ON THE ACTUATOR INTERFACE BOX IS NOT LONGER WORKING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
352710 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET FDX-MCG

Patients

Seq Age Sex Outcome Treatment
1 Other