BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 4231752 · Received November 6, 2014

    Report

    Report Number
    1525712-2014-07674
    Event Type
    Malfunction
    Date Received
    November 6, 2014
    Report Date
    October 17, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CO, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE DEALER IS STATING THAT A PIECE IS MISSING, THE REAR WHEEL IS NOT RIDING EVENLY AND MAKES A POP SOUND. THE DEALER WAS LOOKING FOR A WASHER OR A SPACER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    714563 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI INVACARE TAYLOR STREET HMV4R20

    Patients

    Seq Age Sex Outcome Treatment
    1 Other