BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3903300 · Received June 30, 2014

    Report

    Report Number
    1525712-2014-03305
    Event Type
    Malfunction
    Date Received
    June 30, 2014
    Report Date
    May 30, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OR, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CUSTOMER STATES THE CHAIR TURNS ON AND OFF ON ITS OWN. CUSTOMER WAS CALLING TO REQUEST THE RECALL. ADVISED TO CONTACT (B)(6). CUSTOMER STATES THE WIRING IS FRAYED AND BROKEN AS WELL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    380711 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M51PR

    Patients

    Seq Age Sex Outcome Treatment
    1 Other