BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4222475 · Received November 4, 2014

    Report

    Report Number
    9616091-2014-02350
    Event Type
    Malfunction
    Date Received
    November 4, 2014
    Report Date
    October 14, 2014
    Manufacturer
    INVAMEX
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OK, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE PROVIDER STATES THE COMPOSITE FOOT PLATE ON THE FRONT RIGGING BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    705380 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR INVAMEX TREX20R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other