FDA Adverse Event Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 4045374 · Received August 28, 2014

Report

Report Number
1531186-2014-03453
Date Received
August 28, 2014
Report Date
July 29, 2014
Manufacturer
JUMAO - JM - E. CHINA
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

THE PROVIDER STATES THE BOLT IN THE WHEEL LOCK ASSEMBLY IS STRIPPED AND WILL NOT HOLD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
524289 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR JUMAO - JM - E. CHINA V18RFR

Patients

Seq Age Sex Outcome Treatment
1 Other