BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3962456 · Received July 29, 2014

    Report

    Report Number
    1525712-2014-04027
    Event Type
    Malfunction
    Date Received
    July 29, 2014
    Date of Event
    March 3, 2014
    Report Date
    June 20, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    PER END-USER'S WIFE, UNIT WILL NOT MOVE ON CARPET. ENDUSER STATES WHEELS ARE JUST SPINNING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    442587 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M51

    Patients

    Seq Age Sex Outcome Treatment
    1 Other