BEUDAMED
    FDA Adverse Event Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4222478 · Received November 4, 2014

    Report

    Report Number
    1531186-2014-05327
    Date Received
    November 4, 2014
    Date of Event
    October 12, 2014
    Report Date
    October 14, 2014
    Manufacturer
    JUMAO HEALTHCARE EQUIPMENT
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER ADVISED SOMEONE WAS PUSHING HER IN THE CHAIR AND SHE FELT A BUMP AND NOTICED FRONT RIGHT CASTER RIM WAS BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    705473 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR JUMAO HEALTHCARE EQUIPMENT V18RFR

    Patients

    Seq Age Sex Outcome Treatment
    1 Other