BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3951167 · Received July 22, 2014

    Report

    Report Number
    1525712-2014-03901
    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
    AL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE (B)(4) POWER CHAIR TILT ACTUATOR IS NOT WORKING. END USER ALLEGES GREASE LEAKING ALL OVER HARDWOOD FLOOR AND CARPETS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    428007 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other