BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4113073 · Received September 24, 2014

    Report

    Report Number
    1525712-2014-06248
    Event Type
    Malfunction
    Date Received
    September 24, 2014
    Report Date
    September 5, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES WALKING BEAM OF PRONTO M91 CAUSING MOTOR BRUSH CAP TO RUB ON FRAME RESULTING IN AN ELECTRICAL SHORT AND DAMAGED MOTOR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    593363 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M91R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other