FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3971511 · Received July 31, 2014

Report

Report Number
9616091-2014-01382
Event Type
Malfunction
Date Received
July 31, 2014
Report Date
June 27, 2014
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IS
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

REF S/N (B)(4) DEALER STATES THAT THE TRACER IV LEFT SIDE.FRAME FROM AT THE WELD WHERE THE REAR WHEEL GOES ATTACHEDTO THE FRAME.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
447388 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX T4

Patients

Seq Age Sex Outcome Treatment
1 Other