FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 4123609 · Received September 26, 2014

Report

Report Number
1525712-2014-06375
Event Type
Malfunction
Date Received
September 26, 2014
Report Date
September 8, 2014
Manufacturer
UNKNOWN
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
PATIENT

Narratives

Description of Event or Problem · 1

END USER ADVISED WHEN YOU PUT AIR IN THE WHEEL IT POPS OFF.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
602226 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR UNKNOWN UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Other