BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWER CHAIR 20 WIDE BY 18 DEEP FOR PMI

    MDR report key: 4340235 · Received December 18, 2014

    Report

    Report Number
    1525712-2014-08718
    Event Type
    Malfunction
    Date Received
    December 18, 2014
    Report Date
    November 24, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER IS STATING THAT THE EASY SET MOUNTING HARDWARE IS BROKEN. DEALER IS STATING THAT THE SEA HORSE BRACKET IS CRACKED SIDE TO SIDE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    833851 POWER CHAIR 20 WIDE BY 18 DEEP FOR PMI WHEELCHAIR, POWERED ITI INVACARE TAYLOR STREET TDXSP

    Patients

    Seq Age Sex Outcome Treatment
    1 Other