FDA Adverse Event
Malfunction
Summary report: N
MECHANICAL (MANUAL) WHEELCHAIR
MDR report key: 4131189
·
Received October 1, 2014
Report
- Report Number
- 9616091-2014-02046
- Event Type
- Malfunction
- Date Received
- October 1, 2014
- Report Date
- September 11, 2014
- Manufacturer
- INVAMEX
- Product Code
- IOR
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- MS, US
- Reporter Occupation
- OTHER CAREGIVERS
Narratives
Description of Event or Problem · 1
IT WAS REPORTED BY THE DEALER THAT ONE OF THE CASTER WHEELS IS LOOSE, A PIECE IS BROKEN. NO PATIENT INJURY REPORTED, NO ADDITIONAL INFORMATION PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 612242 | MECHANICAL (MANUAL) WHEELCHAIR | 890.3850 | IOR | INVAMEX | TREX28R |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |