FDA Adverse Event
Malfunction
Summary report: N
WHEELCHAIR COMPONENTS
MDR report key: 4142527
·
Received October 6, 2014
Report
- Report Number
- 9616091-2014-02088
- Event Type
- Malfunction
- Date Received
- October 6, 2014
- Report Date
- September 17, 2014
- Manufacturer
- INVAMEX
- Product Code
- KNN
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- OH, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
PER DEALER FOOTPLATES BROKE AND THEY ARE WARPED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 624744 | WHEELCHAIR COMPONENTS | 890.3920 | KNN | INVAMEX | T93HE_37918 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |