FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3883873 · Received June 19, 2014

Report

Report Number
3008262382-2014-00118
Event Type
Malfunction
Date Received
June 19, 2014
Report Date
May 21, 2014
Manufacturer
INVACARE REHABILITATION EQUIP
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER ALLEGED THE SCREW ON THE SEAT POST LOOSENED AND HOLLOWED OUT THE HOLE CAUSING THE SCREW TO NO LONGER BE ABLE TO BE TIGHTENED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
361580 POWERED WHEELCHAIR 890.3860 ITI INVACARE REHABILITATION EQUIP M41SRB

Patients

Seq Age Sex Outcome Treatment
1 Other