BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3910260 · Received July 2, 2014

    Report

    Report Number
    3008262382-2014-00183
    Event Type
    Malfunction
    Date Received
    July 2, 2014
    Report Date
    May 27, 2014
    Manufacturer
    INVACARE REHABILITATION EQUIP
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER STATES THAT THE CHAIRS THROTTLE BAR IS BROKEN OFF, THAT WHEN HE GOES TO TURN THE DEVICE OFF THE CHAIR SHOOTS FORWARD. STATES THE RUBBER TIP HAS BROKEN OFF AS WELL, BUT DOES NOT SEEM TO AFFECT THE DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    387087 POWERED WHEELCHAIR 890.3860 ITI INVACARE REHABILITATION EQUIP M51

    Patients

    Seq Age Sex Outcome Treatment
    1 Other