FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3902658 · Received June 30, 2014

Report

Report Number
1525712-2014-03253
Event Type
Malfunction
Date Received
June 30, 2014
Report Date
May 28, 2014
Manufacturer
INVACARE TAYLOR STREET
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER THIS IS A BRAND NEW MOTOR AND IT WORKED FOR A FEW DAY THEN IT JUST STOPPED WORKING AND GOT REALLY HOT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
380121 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSPREE

Patients

Seq Age Sex Outcome Treatment
1 Other