BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3911834 · Received July 3, 2014

    Report

    Report Number
    1525712-2014-03417
    Event Type
    Malfunction
    Date Received
    July 3, 2014
    Date of Event
    May 30, 2014
    Report Date
    May 30, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE RIGHT MOTOR ON A M71GVBL POWER CHAIR IS LEAKING GREASE DUE TO SEAL FALLING OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    391257 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M71GVBL

    Patients

    Seq Age Sex Outcome Treatment
    1 Other