BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3875358 · Received June 16, 2014

    Report

    Report Number
    3008262382-2014-00084
    Event Type
    Malfunction
    Date Received
    June 16, 2014
    Date of Event
    May 12, 2014
    Report Date
    May 19, 2014
    Manufacturer
    INVACARE REHABILITATION EQUIP
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    THE END USER'S WIFE ALLEGED THE CHAIR IS VEERING TO THE RIGHT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    352738 POWERED WHEELCHAIR 890.3860 ITI INVACARE REHABILITATION EQUIP M51PSR16B

    Patients

    Seq Age Sex Outcome Treatment
    1 74 Other