BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4111590 · Received September 23, 2014

    Report

    Report Number
    1525712-2014-06218
    Event Type
    Malfunction
    Date Received
    September 23, 2014
    Date of Event
    August 1, 2014
    Report Date
    August 29, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IL, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    UNKNOWN MALFUNCTION. FIRST JOYSTICK FOR THIS UNIT REPLACED EITHER (B)(6) OF 2012.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    591454 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSIV-2

    Patients

    Seq Age Sex Outcome Treatment
    1 Other