BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4130026 · Received September 30, 2014

    Report

    Report Number
    1525712-2014-06510
    Event Type
    Malfunction
    Date Received
    September 30, 2014
    Report Date
    September 11, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER (B)(6) THE LEFT MOTOR IS SHORTING OUT, HE BELIEVES THAT THE INSIDE WIRING HAS A SHORT, THE MOTOR JUST STOPS WORKING.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    609184 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSPREE

    Patients

    Seq Age Sex Outcome Treatment
    1 Other