BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 3964148 · Received July 29, 2014

    Report

    Report Number
    3002416487-2014-00059
    Event Type
    Malfunction
    Date Received
    July 29, 2014
    Report Date
    June 12, 2014
    Manufacturer
    INVACARE CANADA KIRKLAND
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER PROVIDER ARM SOCKET BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    442419 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE CANADA KIRKLAND MYON

    Patients

    Seq Age Sex Outcome Treatment
    1 Other