FDA Adverse Event
Malfunction
Summary report: N
HTR5500 HTR-DELUXE MODEL 5500 9153635378
MDR report key: 4712017
·
Received April 21, 2015
Report
- Report Number
- 1525712-2015-02644
- Event Type
- Malfunction
- Date Received
- April 21, 2015
- Report Date
- April 3, 2015
- Manufacturer
- INVACARE TAYLOR STREET
- Product Code
- FRK
- 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
HTR CHAIR WAS BROKEN AT BASE OF ARM REST. REPLACED WITH HTR (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 262309 | HTR5500 HTR-DELUXE MODEL 5500 9153635378 | CHAIR AND TABLE, MEDICAL | FRK | INVACARE TAYLOR STREET | HTR5500 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |