BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3961430 · Received July 28, 2014

    Report

    Report Number
    9616091-2014-01319
    Event Type
    Malfunction
    Date Received
    July 28, 2014
    Date of Event
    November 4, 2013
    Report Date
    June 20, 2014
    Manufacturer
    INVAMEX
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER'S WIFE ADVISED THE RIGHT SIDE UPPER LEVER BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    438236 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX TREX28R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other