FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3950402 · Received July 22, 2014

Report

Report Number
1525712-2014-03926
Event Type
Malfunction
Date Received
July 22, 2014
Report Date
June 16, 2014
Manufacturer
INVACARE TAYLOR STREET
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

DEALER STATES THE LEFT MOTOR IS GRINDING AND LEAKING OIL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
427919 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSI-HD-S

Patients

Seq Age Sex Outcome Treatment
1 Other