FDA Adverse Event Malfunction Summary report: N

MECHANICAL (MANUAL) WHEELCHAIR

MDR report key: 4211475 · Received October 29, 2014

Report

Report Number
9616091-2014-02280
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
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

THE TBM (B)(6) CALLED IN AND STATES THAT THE LEFT PIVOT TUBE IS PUNCHED INCORRECTLY MAKING THE FOOTPLATE SIT MORE FORWARD THEN THE OTHER SIDE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
694072 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX SOLARA3G

Patients

Seq Age Sex Outcome Treatment
1 Other