FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 4131360 · Received October 1, 2014

Report

Report Number
1525712-2014-06535
Event Type
Malfunction
Date Received
October 1, 2014
Report Date
September 12, 2014
Manufacturer
INVACARE TAYLOR STREET
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

DEALER STATES THE CONSUMER DID SOMETHING TO CAUSE THE FOOTPLATES AND EXT TUBE TO BREAK. NO FURTHER INFORMATION PROVIDED

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
611207 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVACARE TAYLOR STREET TDXSP-CG

Patients

Seq Age Sex Outcome Treatment
1 Other