BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3914016 · Received July 3, 2014

    Report

    Report Number
    9616091-2014-01148
    Event Type
    Malfunction
    Date Received
    July 3, 2014
    Date of Event
    June 3, 2014
    Report Date
    June 3, 2014
    Manufacturer
    INVAMEX
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER ADVISED LEFT MOTOR GEARBOX IS LEAKING GREASE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    390899 POWERED WHEELCHAIR 890.3860 ITI INVAMEX P9000XDT1816

    Patients

    Seq Age Sex Outcome Treatment
    1 Other