BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4133267 · Received October 1, 2014

    Report

    Report Number
    9616091-2014-02060
    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
    TX, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE END USER STATES HER HUSBAND WAS TRANSFERRING OUT OF THE CHAIR AND THE ARM PAD ON THE LEFT HAS BROKEN OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    611669 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX T420RDAP

    Patients

    Seq Age Sex Outcome Treatment
    1 Other