BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    M51P BLUE BASE W/MK5 NX SPJ+ 9153642087

    MDR report key: 4813132 · Received June 2, 2015

    Report

    Report Number
    1525712-2015-03206
    Event Type
    Malfunction
    Date Received
    June 2, 2015
    Report Date
    April 30, 2015
    Manufacturer
    INVACARE
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AZ, US
    Reporter Occupation
    PATIENT

    Narratives

    Additional Manufacturer Narrative · 1

    SHOULD ADDITIONAL INFORMATION BECOME AVAILABLE A SUPPLEMENTAL RECORD WILL BE FILED.

    Description of Event or Problem · 1

    ENDUSER ADVISED END OF THE PLUG THAT GOES INTO THE BACK OF THE CHAIR TO CHARGE CHAIR CAME OFF, BATTERIES DO NOT HOLD A CHARGE. ENDUSER ADVISED STUCK OUTSIDE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    354215 M51P BLUE BASE W/MK5 NX SPJ+ 9153642087 WHEELCHAIR, POWERED ITI INVACARE M51PSCTRSTR

    Patients

    Seq Age Sex Outcome Treatment
    1 Other