BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3883969 · Received June 19, 2014

    Report

    Report Number
    1056571-2014-00023
    Event Type
    Malfunction
    Date Received
    June 19, 2014
    Report Date
    May 20, 2014
    Manufacturer
    INVACARE TOP END
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATED THAT THE MOUNTING SCREWS ON A (B)(4) WHEELCHAIR FOR THE LEFT SIDE CAMBER TUBE CLAMP HAVE SHEARED OFF AND THE ANTI TIPPER ON THE LEFT SIDE CANNOT BE MOUNTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    361296 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TOP END CT7A

    Patients

    Seq Age Sex Outcome Treatment
    1 Other