BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4220217 · Received November 3, 2014

    Report

    Report Number
    1525712-2014-07543
    Event Type
    Malfunction
    Date Received
    November 3, 2014
    Report Date
    October 14, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    END USER NEIGHBOR IS REPORTING THAT THE CHAIR KEEPS STOPPING. THEY JUST REPLACED THE BATTERIES. SHE WAS STRANDED AT (B)(6) IN PARKING LOT THE OTHER DAY. NO INJURY REPORTED. END USER STATES THAT (B)(6) REFUSES TO ASSIST THEM, WILL NOT EVEN ORDER THEM PARTS. I GAVE THEM SERVICE CENTER NUMBERS IN THE AREA.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    701664 POWERED WHEELCHAIR 890.3860 ITI UNKNOWN M91

    Patients

    Seq Age Sex Outcome Treatment
    1 Other