BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MECHANICAL (MANUAL) WHEELCHAIR

    MDR report key: 4223041 · Received November 4, 2014

    Report

    Report Number
    1525712-2014-07606
    Event Type
    Malfunction
    Date Received
    November 4, 2014
    Report Date
    October 16, 2014
    Manufacturer
    UNKNOWN
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE DEALER ALLEGES THERE IS A PIECE AT THE BACK/BOTTOM OF THE SEAT OF THE UNKNOWN CHAIR THAT IS BROKEN. HE STATED THAT IT APPEARS TO BE ATTACHED TO THE LOOP ON THE SEAT BELT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    708047 MECHANICAL (MANUAL) WHEELCHAIR 890.3850 IOR UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other