BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3880411 · Received June 18, 2014

    Report

    Report Number
    1525712-2014-03016
    Event Type
    Malfunction
    Date Received
    June 18, 2014
    Report Date
    May 20, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OR, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER REPORTS FRONT CASTERS LODGED UP AGAINST DRIVE WHEELS WHEN THE USER WAS COMING OFF THE RAMP CAUSING HER TO LUNGE FORWARD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    357141 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-MCG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other