BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL CHAIR/TRANSPORT CHAIR

    MDR report key: 3884632 · Received June 19, 2014

    Report

    Report Number
    1531186-2014-02196
    Date Received
    June 19, 2014
    Report Date
    May 20, 2014
    Manufacturer
    JAEYONG
    Product Code
    INM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    UT, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    PER CUSTOMER THE REAR WHEEL WAS BROKEN. SHE STATED ONE SPOKE WAS BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    360504 MECHANICAL CHAIR/TRANSPORT CHAIR 890.3100 INM JAEYONG LTTB17FR

    Patients

    Seq Age Sex Outcome Treatment
    1 Other