BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL CHAIR/TRANSPORT CHAIR

    MDR report key: 4047120 · Received August 29, 2014

    Report

    Report Number
    1525712-2014-05233
    Event Type
    Malfunction
    Date Received
    August 29, 2014
    Report Date
    August 1, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    INM
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    HTR 5000 CHAIR - THE BEARING ON THE FRONT CASTER STEM COMPLETELY FELL OUT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    530107 MECHANICAL CHAIR/TRANSPORT CHAIR 890.3100 INM INVACARE TAYLOR STREET HTR5000

    Patients

    Seq Age Sex Outcome Treatment
    1 Other