BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TRSX5/WD06/18FB/BH16/ADULT/U2222C/1228/U240 9153653561

    MDR report key: 4372915 · Received December 31, 2014

    Report

    Report Number
    9616091-2014-02456
    Event Type
    Malfunction
    Date Received
    December 31, 2014
    Report Date
    October 27, 2014
    Manufacturer
    INVAMEX
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THEY RENT WHEELCHAIRS AND THIS CHAIR WAS GOING TO BE CLEANED AND TECH NOTICED THAT THE CROSSRACE WAS BENT. PROVIDER GAVE PART NUMBER 1110002 WANTED TO VERIFY THAT HE NEEDED THAT PART TO REPLACE AND REPAIR THE CHAIR.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    862902 TRSX5/WD06/18FB/BH16/ADULT/U2222C/1228/U240 9153653561 WHEELCHAIR, MECHANICAL IOR INVAMEX TRSX5

    Patients

    Seq Age Sex Outcome Treatment
    1 Other