BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PRONTO M41 BLUE BASE 9153645762

    MDR report key: 4390160 · Received January 7, 2015

    Report

    Report Number
    3008262382-2015-00024
    Event Type
    Malfunction
    Date Received
    January 7, 2015
    Report Date
    December 15, 2014
    Manufacturer
    INVACARE REHABILITATION EQUIP
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED BY DEALER THAT THE (B)(4) POWER CHAIR WILL GO A FEW FEET AND THEN STOP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    11376 PRONTO M41 BLUE BASE 9153645762 WHEELCHAIR, POWERED ITI INVACARE REHABILITATION EQUIP M41SRB

    Patients

    Seq Age Sex Outcome Treatment
    1 Other