BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4100195 · Received September 18, 2014

    Report

    Report Number
    1525712-2014-06038
    Event Type
    Malfunction
    Date Received
    September 18, 2014
    Report Date
    August 28, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    TILT IS STUCK IN THE RECLINE POSITION. (B)(6) IN TECH ADVISED, MAY BE JOYSTICK, LOCKOUT SWITCH, OR MAYBE EVEN A LOOSE CONNECTION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    578729 POWERED WHEELCHAIR 890.3860 ITI UNKNOWN TDXSP

    Patients

    Seq Age Sex Outcome Treatment
    1 Other