FDA Adverse Event
Malfunction
Summary report: N
POWERED WHEELCHAIR
MDR report key: 3884400
·
Received June 19, 2014
Report
- Report Number
- 1525712-2014-03049
- Event Type
- Malfunction
- Date Received
- June 19, 2014
- Report Date
- May 21, 2014
- Manufacturer
- INVACARE TAYLOR STREET
- Product Code
- ITI
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NY, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT THE M94 POWER WHEEL CHAIR BRAKE LEVER ON LEFT WILL ALLOW CHAIR TO DRIVE HALFWAY ENGAGED, BUT NOT FULLY ENGAGED. GIVING INTERMITTENT MOTOR AND BRAKE FAULTS ON THAT SIDE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 361919 | POWERED WHEELCHAIR | 890.3860 | ITI | INVACARE TAYLOR STREET | M94 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |