BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4103118 · Received September 19, 2014

    Report

    Report Number
    1525712-2014-06070
    Event Type
    Malfunction
    Date Received
    September 19, 2014
    Date of Event
    August 26, 2014
    Report Date
    August 29, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VT, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE PROVIDER STATES THAT THE USERS BACK UPHOLSTERY IS WEARING OUT. THERE WAS NO ADDITIONAL INFORMATION PROVIDED. ITEM DESCRIPTION: BACK ANCHOR 14-20 INWX14-18 INH 9153627217.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    582018 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET TA4

    Patients

    Seq Age Sex Outcome Treatment
    1 Other