FDA Adverse Event Malfunction Summary report: N

POWERED WHEELCHAIR

MDR report key: 3974736 · Received August 4, 2014

Report

Report Number
1525712-2014-04091
Event Type
Malfunction
Date Received
August 4, 2014
Report Date
June 23, 2014
Manufacturer
INVACARE TAYLOR STREET
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER THE DEALER, THE MOTOR GEARBOX IS LEAKING.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
454984 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

Patients

Seq Age Sex Outcome Treatment
1 Other