BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TDXSP ELECTRIC RED EURO WIDE BASE W/ 23-1 SSD GEAR BOX

    MDR report key: 4412003 · Received January 13, 2015

    Report

    Report Number
    1525712-2014-08579
    Event Type
    Malfunction
    Date Received
    January 13, 2015
    Report Date
    November 18, 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 ALLEGES THE TILT ACTUATOR WAS GRINDING AND WENT OUT ON A TDXSR-NCG POWER CHAIR CAUSING THE USER TO BE STRANDED IN THE UP POSITION. DEALER WAS CALLED TO GET THE PATIENT DOWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    28890 TDXSP ELECTRIC RED EURO WIDE BASE W/ 23-1 SSD GEAR BOX WHEELCHAIR, POWERED ITI INVACARE TAYLOR STREET TDXSR-MCG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other