FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 4111052 · Received September 23, 2014

Report

Report Number
9616091-2014-01953
Event Type
Malfunction
Date Received
September 23, 2014
Date of Event
September 3, 2014
Report Date
September 3, 2014
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IN, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

IT HAS BEEN REPORTED BY THE DEALER THAT THE PART DOWN BY THE FOOTPLATE OF AN ELEVATING LEGREST ON A TREX28R WHEELCHAIR IS BROKEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
591547 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX TREX28R

Patients

Seq Age Sex Outcome Treatment
1 Other