BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    TRACER TRANSPORT CHAIR 19 X 16 9153647029

    MDR report key: 4874850 · Received June 29, 2015

    Report

    Report Number
    9616091-2015-01669
    Event Type
    Malfunction
    Date Received
    June 29, 2015
    Report Date
    June 2, 2015
    Manufacturer
    INVAMEX
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    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

    DEALER IS STATING THAT THE REAR WHEEL IS WARPED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    420351 TRACER TRANSPORT CHAIR 19 X 16 9153647029 WHEELCHAIR, MECHANICAL IOR INVAMEX T4

    Patients

    Seq Age Sex Outcome Treatment
    1 Other