BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4134040 · Received October 2, 2014

    Report

    Report Number
    1531186-2014-04645
    Date Received
    October 2, 2014
    Date of Event
    September 13, 2014
    Report Date
    September 15, 2014
    Manufacturer
    JUMAO HEALTHCARE EQUIPMENT
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KY, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    END USER ALLEGES HE SAT DOWN IN THE (B)(4) WHEELCHAIR AND HEARD A CRACK AND NOTICED A SPOKE WAS BROKEN ON LEFT WHEEL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    617124 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR JUMAO HEALTHCARE EQUIPMENT TRSX50FB

    Patients

    Seq Age Sex Outcome Treatment
    1 Other