BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3910073 · Received July 2, 2014

    Report

    Report Number
    1525712-2014-03348
    Event Type
    Malfunction
    Date Received
    July 2, 2014
    Date of Event
    May 29, 2014
    Report Date
    May 29, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER PROVIDER THE RIGHT BACK CANE IS BROKEN RIGHT AT THE BASE. THIS IS THE THIRD TIME THAT BACK CANES HAVE BROKEN. THE FIRST TIME BOTH CANES BROKE. THE SECOND TIME THE LEFT CANE BROKE. USER HAS TONE AND BOUNCES IN THE CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    387212 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET SOLARA3G

    Patients

    Seq Age Sex Outcome Treatment
    1 Other