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