FDA Adverse Event Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 3980590 · Received August 5, 2014

Report

Report Number
1531186-2014-02985
Date Received
August 5, 2014
Report Date
July 3, 2014
Manufacturer
UNKNOWN
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES BROKEN SPOKE ON WHEEL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
457648 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR UNKNOWN TREX2

Patients

Seq Age Sex Outcome Treatment
1 Other