BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3896941 · Received June 26, 2014

    Report

    Report Number
    1525712-2014-03201
    Event Type
    Malfunction
    Date Received
    June 26, 2014
    Report Date
    May 27, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CONSUMER STATES THAT HE WAS DRIVING DOWN THE ROAD IN HIS CHAIR AND IT WAS ABOUT 9PM AND THE CHAIR JUST STOPPED AND THE LIGHTS SHUT OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    374142 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 61 Other