FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3951730 · Received July 23, 2014

Report

Report Number
1525712-2014-03907
Event Type
Malfunction
Date Received
July 23, 2014
Report Date
June 17, 2014
Manufacturer
INVACARE TAYLOR STREET
Product Code
ITI
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

PER DEALER, THE LEFT MOTOR WAS LEAKING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
430267 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP

Patients

Seq Age Sex Outcome Treatment
1 Other