FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3943673 · Received July 18, 2014

Report

Report Number
9616091-2014-01229
Event Type
Malfunction
Date Received
July 18, 2014
Report Date
June 11, 2014
Manufacturer
INVAMEX
Product Code
IOR
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

THE FOOTREST BROKE ON THE HANGER ON THE RIGHT SIDE PER PROVIDER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
421879 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX T420RFA

Patients

Seq Age Sex Outcome Treatment
1 Other