FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 4132968 · Received October 1, 2014

Report

Report Number
9616091-2014-02052
Event Type
Malfunction
Date Received
October 1, 2014
Report Date
September 12, 2014
Manufacturer
INVAMEX
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WI, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

CUSTOMER ALLEGES THE PORTION OF THE ONE ARM DRIVE IS HITTING THE BOTTOM OF THE TRSX5 WHEELCHAIR CAUSING TEARING AND BOTTOMING OUT IN THE SEAT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
613309 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX TRSX5

Patients

Seq Age Sex Outcome Treatment
1 Other