BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3880475 · Received June 18, 2014

    Report

    Report Number
    1525712-2014-03031
    Event Type
    Malfunction
    Date Received
    June 18, 2014
    Report Date
    May 21, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    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

    PER DEALER THE WIRE WAS PULLED OUT OF THIS UNIT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    358661 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSR-MCG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other