BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4002268 · Received August 12, 2014

    Report

    Report Number
    1531186-2014-03141
    Date Received
    August 12, 2014
    Report Date
    July 9, 2014
    Manufacturer
    JUMAO - JM - E. CHINA
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED BY THE PROVIDER THAT THE END USER FELL DUE TO BOTH FRONT CASTER HAVING BROKEN SPOKES. THE END USER DIDN'T COMPLAIN OF INJURIES BUT THE FORKS ARE BENT DUE TO THE FALL. NO ADDITIONAL INFORMATION PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    480288 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR JUMAO - JM - E. CHINA V18RLR

    Patients

    Seq Age Sex Outcome Treatment
    1 Other