BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4130073 · Received September 30, 2014

    Report

    Report Number
    1525712-2014-06511
    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
    IL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDED STATES THAT THE LEFT MOTOR IS GETTING NO OUTPUT. NO ADDITIONAL INFORMATION PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    607726 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET TDXSI

    Patients

    Seq Age Sex Outcome Treatment
    1 Other