FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 4120316 · Received September 26, 2014

Report

Report Number
9616091-2014-01984
Event Type
Malfunction
Date Received
September 26, 2014
Report Date
June 13, 2014
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PER PROVIDER, PIVOT LINK CAME BROKEN ON CHAIR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
601652 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX 9XT

Patients

Seq Age Sex Outcome Treatment
1 Other