BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3931172 · Received July 14, 2014

    Report

    Report Number
    9616091-2014-01191
    Event Type
    Injury
    Date Received
    July 14, 2014
    Report Date
    June 6, 2014
    Manufacturer
    INVAMEX
    Product Code
    IOR
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER ALLEGED THAT THE CHAIR TIPPED BACKWARDS AND HE HIT HIS HEAD ON THE GROUND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    410739 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX T420RDA

    Patients

    Seq Age Sex Outcome Treatment
    1 Other