FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3971393 · Received July 31, 2014

Report

Report Number
1525712-2014-04204
Event Type
Malfunction
Date Received
July 31, 2014
Report Date
June 26, 2014
Manufacturer
INVACARE TAYLOR STREET
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
KY, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER, THE CONTROLLER IS DEFECTIVE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
448398 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M91

Patients

Seq Age Sex Outcome Treatment
1 Other