BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4211310 · Received October 29, 2014

    Report

    Report Number
    9616091-2014-02288
    Event Type
    Malfunction
    Date Received
    October 29, 2014
    Report Date
    October 9, 2014
    Manufacturer
    INVAMEX
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    TECHNICIAN FOR VA CALLED AND ADVISED BOTH WHEELS ARE BENT CAUSING THEM TO WOBBLE ON T4. TECHNICIAN ADVISED LOOKS LIKE RIGHT SIDE TIRE IS NOT SEATED ALL THE WAY IN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    693676 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX T4

    Patients

    Seq Age Sex Outcome Treatment
    1 Other