BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3902390 · Received June 30, 2014

    Report

    Report Number
    1525712-2014-03246
    Event Type
    Malfunction
    Date Received
    June 30, 2014
    Report Date
    May 28, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WI, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    THE END USER ALLEGES THE CORD THAT GOES FROM THE JOYSTICK TO THE CONTROLLER IS SHOCKING HIM ON A M51 POWER CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    380667 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M51

    Patients

    Seq Age Sex Outcome Treatment
    1 Other