FDA Adverse Event Malfunction Summary report: N

SOLARA 3G LTD 20W 24 COM 9153653250

MDR report key: 5242931 · Received November 23, 2015

Report

Report Number
1525712-2015-05294
Event Type
Malfunction
Date Received
November 23, 2015
Report Date
November 3, 2015
Manufacturer
INVACARE TAYLOR STREET
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

REPAIR TECHNICIAN OBSERVED DEFECTIVE WELD ON FRAME AT BRACKET WHERE BACKREST RECLINE MECHANISM ATTACHED. THE REA AZALEA IS THE SAME /SIMILAR TO THE SOLARA 3G WHICH IS MANUFACTURED AND/OR MARKETED BY INVACARE IN THE U.S. THE ALLEGED INCIDENT OCCURRED IN (B)(6).

Description of Event or Problem · 1

REPAIR TECHNICIAN OBSERVED DEFECTIVE WELD ON FRAME AT BRACKET WHERE BACKREST RECLINE MECHANISM ATTACHED. THE REA AZALEA IS THE SAME /SIMILAR TO THE SOLARA 3G WHICH IS MANUFACTURED AND/OR MARKETED BY INVACARE IN THE U.S. THE ALLEGED INCIDENT OCCURRED IN (B)(6).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
772871 SOLARA 3G LTD 20W 24 COM 9153653250 WHEELCHAIR, MECHANICAL IOR INVACARE TAYLOR STREET SOLARA3G

Patients

Seq Age Sex Outcome Treatment
1