FDA Adverse Event
Malfunction
Summary report: N
TRACER TRANSPORT CHAIR 19 X 16 9153647029
MDR report key: 5007893
·
Received August 17, 2015
Report
- Report Number
- 1525712-2015-04296
- Event Type
- Malfunction
- Date Received
- August 17, 2015
- Report Date
- July 23, 2015
- Manufacturer
- INVACARE TAYLOR STREET
- Product Code
- IOR
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IL, 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 STATES RIGHT SIDE FRAME BROKE WHERE THE BACK CANE ATTACHES.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 542548 | TRACER TRANSPORT CHAIR 19 X 16 9153647029 | WHEELCHAIR, MECHANICAL | IOR | INVACARE TAYLOR STREET | PATRIOT |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |