BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4039949 · Received August 27, 2014

    Report

    Report Number
    1525712-2014-05130
    Event Type
    Malfunction
    Date Received
    August 27, 2014
    Report Date
    August 4, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER STATED THAT HE REPLACED GEARBOX. NOW THE JOYSTICK WILL MOVE ONLY ONE WHEEL IF HE MOVES TO THE JOYSTICK TO RIGHT THE CHAIR GOES BACKWARDS, IF HE MOVES JOYSTICK THE OPPOSITE WAY THE CHAIR GOES FORWARD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    520385 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET 3GTQ-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other