BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3883971 · Received June 19, 2014

    Report

    Report Number
    3008262382-2014-00122
    Event Type
    Malfunction
    Date Received
    June 19, 2014
    Date of Event
    May 21, 2014
    Report Date
    May 20, 2014
    Manufacturer
    INVACARE REHABILITATION EQUIP
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER ALLEGES THE SEAT FRAME BRACKET BROKE ON A M51PSEMIBLUE POWER CHAIR CAUSING SEAT TO STAY FORWARD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    361429 POWERED WHEELCHAIR 890.3860 ITI INVACARE REHABILITATION EQUIP M51PSEMIBLUE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other