BEUDAMED
    FDA Adverse Event Injury Summary report: N

    INVACARE POWER WHEELCHAIR

    MDR report key: 579299 · Received March 7, 2005

    Report

    Report Number
    1525712-2005-00013
    Event Type
    Injury
    Date Received
    March 7, 2005
    Date of Event
    August 24, 2004
    Report Date
    March 3, 2005
    Manufacturer
    INVACARE CORP. - MANUFACTURING FACILITY
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NO INFORMATION

    Narratives

    Description of Event or Problem · 1

    THE CONSUMER ALLEGES THE WHEELCHAIR "SHIMMY'S AND JERKS AND THE TIRE WENT CRAZY" AND ALLEGEDLY THREW CONSUMER FROM THE CHAIR, CAUSING CONSUMER TO BREAK THEIR FOOT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 INVACARE POWER WHEELCHAIR 890.3860 ITI INVACARE CORP. - MANUFACTURING FACILITY TDX3 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 * Required Intervention