BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4090193 · Received September 15, 2014

    Report

    Report Number
    1525712-2014-05857
    Event Type
    Malfunction
    Date Received
    September 15, 2014
    Report Date
    August 22, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES, WALKING BEAMS ARE STICKING, WHEN PATIENT GOES OVER THRESHOLD THE REAR WHEELS ARE STAYING IN A UPWARD POSITION, NOT STAYING ON THE GROUND. (LEFT)

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    568785 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M94-C

    Patients

    Seq Age Sex Outcome Treatment
    1 Other