BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4152633 · Received October 8, 2014

    Report

    Report Number
    9616091-2014-02125
    Event Type
    Malfunction
    Date Received
    October 8, 2014
    Report Date
    September 22, 2014
    Manufacturer
    INVAMEX
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER PROVIDER THE WELD HAS BROKEN THE CUP ASSEMBLY. REAR-LEFT. THE BRACKET WITH 4 HOLES HAS COME APART AT THE WELD FROM THE RECEIVING CUP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    631224 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX SOLARA3G

    Patients

    Seq Age Sex Outcome Treatment
    1 Other