BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 4243259 · Received November 11, 2014

    Report

    Report Number
    3008262382-2014-01946
    Event Type
    Malfunction
    Date Received
    November 11, 2014
    Report Date
    October 23, 2014
    Manufacturer
    INVACARE REHABILITATION EQUIP
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    THE PROVIDER STATES THE CHAIR WILL DRIVE AROUND AND JERK BUT NEVER SHUT DOWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    725837 POWERED WHEELCHAIR 890.3860 ITI INVACARE REHABILITATION EQUIP M51PSR20R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other