BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PRONTO M41 BLUE BASE 9153645762

    MDR report key: 5192993 · Received October 30, 2015

    Report

    Report Number
    3008262382-2015-01871
    Event Type
    Malfunction
    Date Received
    October 30, 2015
    Report Date
    August 14, 2015
    Manufacturer
    INVACARE REHABILITATION EQUIPMENT CO.
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, 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

    THE PROVIDER STATES THE SEAT BROKE BY WHERE THE FRAME MEETS THE SEAT POST.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    722893 PRONTO M41 BLUE BASE 9153645762 WHEELCHAIR, POWERED ITI INVACARE REHABILITATION EQUIPMENT CO. M41RSOLIDB

    Patients

    Seq Age Sex Outcome Treatment
    1