BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4122710 · Received September 26, 2014

    Report

    Report Number
    1525712-2014-06397
    Event Type
    Malfunction
    Date Received
    September 26, 2014
    Date of Event
    September 4, 2014
    Report Date
    September 9, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CONSUMER STATES THERE ARE TWO BOLTS ON THE LEFT SIDE ABOVE THE CASTERS THAT ARE BENT AND ONE IS BROKEN WHICH IS CAUSING THAT LEFT CASTER IS BENT BACKWARDS TOWARDS THE REAR WHEEL AND DOES NOT ENTIRELY TOUCH THE GROUND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    602034 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET MVPS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other