BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TDXSP WET BLACK EURO NARROW BASE W/ 18-1 SSD GEAR BOX

    MDR report key: 4414059 · Received January 13, 2015

    Report

    Report Number
    1525712-2015-00294
    Event Type
    Malfunction
    Date Received
    January 13, 2015
    Report Date
    December 30, 2014
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER STATES THAT THE LNX LEG ACTUATOR BENT AND GEAR SCREWED OUT. NO FURTHER INFORMATION IS AVAILABLE. UNABLE TO ACCESS PROTOCOL QUESTIONS UNABLE TO ATTACH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    30562 TDXSP WET BLACK EURO NARROW BASE W/ 18-1 SSD GEAR BOX WHEELCHAIR, POWERED ITI INVACARE TAYLOR STREET TDXSP-MCG

    Patients

    Seq Age Sex Outcome Treatment
    1 Other