BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4132867 · Received October 1, 2014

    Report

    Report Number
    1525712-2014-06546
    Event Type
    Malfunction
    Date Received
    October 1, 2014
    Report Date
    September 12, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NC, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    SERIAL NUMBER WAS UNABLE TO BE VERIFIED AT THIS TIME.

    Description of Event or Problem · 1

    DEALER STATED THE JOYSTICK CABLES SOMEHOW GOT TANGLED AND FRAYED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    613244 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other