FDA Adverse Event
Malfunction
Summary report: N
MECHANICAL (MANUAL) WHEELCHAIR
MDR report key: 3894929
·
Received June 25, 2014
Report
- Report Number
- 9616091-2014-01079
- Event Type
- Malfunction
- Date Received
- June 25, 2014
- Report Date
- May 27, 2014
- Manufacturer
- INVAMEX
- Product Code
- IOR
- 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 STATED THAT A REAR WHEEL ON A T4X24RDAP WHEELCHAIR HAS A BROKEN SPOKE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 369930 | MECHANICAL (MANUAL) WHEELCHAIR | 890.3850 | IOR | INVAMEX | T4X24RDAP |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |