FDA Adverse Event
Malfunction
Summary report: N
POWERED WHEELCHAIR
MDR report key: 3914166
·
Received July 3, 2014
Report
- Report Number
- 1525712-2014-03457
- Event Type
- Malfunction
- Date Received
- July 3, 2014
- Report Date
- June 3, 2014
- Manufacturer
- INVACARE TAYLOR STREET
- Product Code
- ITI
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OH, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
IT WAS REPORTED THAT THE TDXSP-CG POWER CHAIR SCREEN IS SMASHED. UNSURE HOW DAMAGE OCCURRED BUT END USER DOES NOT KNOW THE STATUS OF THE CHAIR. UNABLE TO READ WHAT FAULTS HE IS GETTING ON THE CHAIR.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 390844 | POWERED WHEELCHAIR | 890.3860 | ITI | INVACARE TAYLOR STREET | TDXSP-CG |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |