BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4170981 · Received October 14, 2014

    Report

    Report Number
    1525712-2014-06965
    Event Type
    Malfunction
    Date Received
    October 14, 2014
    Report Date
    September 24, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITI
    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

    IT WAS REPORTED THAT THE M51P POWER CHAIR CENTER SEAT POST BOLT KEEPS BREAKING AND THEY HAVE TO BE DRILLED OUT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    651775 POWERED WHEELCHAIR 890.3860 ITI UNKNOWN M51P

    Patients

    Seq Age Sex Outcome Treatment
    1 Other