FDA Adverse Event Malfunction Summary report: N

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

MDR report key: 4851364 · Received June 17, 2015

Report

Report Number
1525712-2015-03476
Event Type
Malfunction
Date Received
June 17, 2015
Report Date
May 20, 2015
Manufacturer
INVACARE TAYLOR STREET
Product Code
ITI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
PHYSICIST

Narratives

Additional Manufacturer Narrative · 1

A FOLLOW UP WILL BE SENT IF THE PRODUCT OR ADDITIONAL INFORMATION IS OBTAINED.

Description of Event or Problem · 1

PROVIDER STATES THAT THE FOOTPLATE IS BENT DOWN. PROVIDER STATES THAT THERE IS MUD ON THE TIRES AND CHAIR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
395294 TDXSP ELECTRIC RED EURO WIDE BASE W/ 23-1 SSD GEAR BOX WHEELCHAIR, POWERED ITI INVACARE TAYLOR STREET TDXSP-MCG

Patients

Seq Age Sex Outcome Treatment
1 Other