BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4234150 · Received November 7, 2014

    Report

    Report Number
    1525712-2014-07689
    Event Type
    Malfunction
    Date Received
    November 7, 2014
    Report Date
    October 20, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    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

    DEALER ALLEGES THE 3GAR-TS POWER CHAIR IS SURGING FORWARD FAST AT PACE WHEN THE CHAIR IS ON THE SLOWEST SPEED INTERMITTENTLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    719182 POWERED WHEELCHAIR 890.3860 ITI INVACARE TAYLOR STREET 3GAR-TS

    Patients

    Seq Age Sex Outcome Treatment
    1 Other