BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3971592 · Received July 31, 2014

    Report

    Report Number
    1525712-2014-04210
    Event Type
    Malfunction
    Date Received
    July 31, 2014
    Date of Event
    June 25, 2014
    Report Date
    June 26, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER ADVISED USED CHAIR TO GET HUSBAND INTO THE CAR CAME BACK LATER AND CHAIR WILL NOT START, NO INJURY, DEALER COULD NOT PROVIDE ANY FURTHER INFORMATION

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    447496 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M91

    Patients

    Seq Age Sex Outcome Treatment
    1 Other