BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4033650 · Received August 25, 2014

    Report

    Report Number
    1525712-2014-04965
    Event Type
    Malfunction
    Date Received
    August 25, 2014
    Report Date
    July 28, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE END USER STATES THE FRONT FORK ON HIS DAUGHTERS CHAIR IS BROKEN. HE STATES THEY WERE IN A RESTAURANT AND THE FORK DISINTEGRATED. THE END USER STATES THEY HAVE A MULTITUDE OF CAREGIVERS WHO TAKE CARE OF HIS DAUGHTER AND SOME OF THEM ARE NOT SO GENTLE ON THE CHAIR. THERE WERE NO REPORTS OF ANY ADVERSE PATIENT EFFECTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    514369 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET SPREE3G

    Patients

    Seq Age Sex Outcome Treatment
    1 Other