BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4140809 · Received October 3, 2014

    Report

    Report Number
    1525712-2014-06679
    Event Type
    Malfunction
    Date Received
    October 3, 2014
    Report Date
    September 17, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE FOOT REST SUPPORT BAR HAS BEEN BENT ON THE M91 POWER CHAIR. THE SON WAS OUT FOR A WALK ON (B)(6), PARENTS DID NOT NOTICE IT WAS BENT UNTIL THE MORNING AFTER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    620637 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET M91

    Patients

    Seq Age Sex Outcome Treatment
    1 Other