BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4062459 · Received September 5, 2014

    Report

    Report Number
    1531186-2014-03842
    Date Received
    September 5, 2014
    Date of Event
    August 6, 2014
    Report Date
    August 6, 2014
    Manufacturer
    JUMAO - JM - E. CHINA
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED BY THE CUSTOMER THAT THE RIGHT REAR WHEEL CAME OFF, GOING INTO DRIVE IN THE OFFICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    544732 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR JUMAO - JM - E. CHINA V18RLR

    Patients

    Seq Age Sex Outcome Treatment
    1 38 MO Other