BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FDX BASE EUROPE W/14 IN REAR WHEELS

    MDR report key: 4350703 · Received December 22, 2014

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    Report

    Report Number
    1525712-2014-08129
    Event Type
    Malfunction
    Date Received
    December 22, 2014
    Report Date
    November 4, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER ALLEGES THE ACTUATOR SPLIT ON A FDX-MCG POWER CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    842718 FDX BASE EUROPE W/14 IN REAR WHEELS WHEELCHAIR, POWERED ITI INVACARE TAYLOR STREET FDX-MCG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other