BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

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

    MDR report key: 5049969 · Received September 2, 2015

    Report

    Report Number
    1525712-2015-04446
    Event Type
    Malfunction
    Date Received
    September 2, 2015
    Report Date
    August 7, 2015
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TN, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

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

    Description of Event or Problem · 1

    PROVIDER STATES THE END USER ALLEGES THE JOYSTICK WAS SMOKING AND THE END OF THE JOYSTICK CABLE CONNECTION WAS MELTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    583250 TDXSP ELECTRIC RED EURO WIDE BASE W/ 23-1 SSD GEAR BOX WHEELCHAIR, POWERED ITI INVACARE TAYLOR STREET TDXSIV-HD

    Patients

    Seq Age Sex Outcome Treatment
    1 Other