BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3930189 · Received July 11, 2014

    Report

    Report Number
    3008262382-2014-00253
    Event Type
    Malfunction
    Date Received
    July 11, 2014
    Report Date
    June 6, 2014
    Manufacturer
    INVACARE REHABILITATION EQUIP
    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

    (B)(4) THE PROVIDER STATES BOTH THE LEFT AND RIGHT MOTORS NEED REPLACED. THE PROVIDER STATES BOTH WHEELS ARE NOT TURNING AND THE CHAIR IS STUTTERING 7857HF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    406192 POWERED WHEELCHAIR 890.3860 ITI INVACARE REHABILITATION EQUIP M41SR20R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other