BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4211439 · Received October 29, 2014

    Report

    Report Number
    1525712-2014-07394
    Event Type
    Malfunction
    Date Received
    October 29, 2014
    Report Date
    October 9, 2014
    Manufacturer
    UNKNOWN
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE PROVIDER STATES THE WELDS ON THE FRONT RIGGING HAVE BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    694031 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR UNKNOWN TOPENDPARTS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other