BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4123459 · Received September 26, 2014

    Report

    Report Number
    1525712-2014-06404
    Event Type
    Malfunction
    Date Received
    September 26, 2014
    Report Date
    June 13, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THAT THE BOOT ON THE JOYSTICK WAS PULLED OFF AND THE USER MAY HAVE SPILLED SOME TYPE OF LIQUID IN THE HOLE. THE PROVIDER CAN SEE A BURN ON THE CIRCUIT BOARD THAT LOOKS TO BE CAUSED BY LIQUID. NO ADDITIONAL INFORMATION PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    602346 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSP-CG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other