FDA Adverse Event Malfunction Summary report: N

POWER CHAIR 20 WIDE BY 18 DEEP FOR PMI

MDR report key: 4567778 · Received March 4, 2015

Report

Report Number
1525712-2015-01578
Event Type
Malfunction
Date Received
March 4, 2015
Report Date
February 24, 2015
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 STATES THE EXTENDING ASSEMBLY ON THE LNX ELEVATING LEGREST ON THIS CHAIR IS BENT AND JAMMED UP THE ACTUATOR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
151756 POWER CHAIR 20 WIDE BY 18 DEEP FOR PMI WHEELCHAIR, POWERED ITI INVACARE TAYLOR STREET TDXSPSEAT

Patients

Seq Age Sex Outcome Treatment
1 Other