BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    NON AC-POWERED PATIENT LIFT

    MDR report key: 3935237 · Received July 15, 2014

    Report

    Report Number
    3008262382-2014-00286
    Event Type
    Malfunction
    Date Received
    July 15, 2014
    Report Date
    June 9, 2014
    Manufacturer
    INVACARE REHABILITATION EQUIP
    Product Code
    FSA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    CUSTOMER STATES ONE OF THE FRONT WHEELS FELL SOMEWHAT APART. THEY STATES IT POPPED OFF, BUT THEN DESCRIBED THAT ONE SIDE OF THE CASTER POPPED OFF. REST OF CASTER STILL ATTACHED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    414010 NON AC-POWERED PATIENT LIFT 880.5510 FSA INVACARE REHABILITATION EQUIP ILIFTEE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other