BEUDAMED
    FDA Adverse Event Injury Summary report: N

    TILITE TRC

    MDR report key: 645977 · Received November 10, 2005

    Report

    Report Number
    3032618-2005-00001
    Event Type
    Injury
    Date Received
    November 10, 2005
    Date of Event
    March 1, 2003
    Report Date
    November 10, 2005
    Manufacturer
    TISPORT, LLC
    Product Code
    IOR
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    THE CONSUMER ALLEGES THAT THE WHEELCHAIR CAUSED THE CONSUMER TO DEVELOP DECUBITUS ULCERS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TILITE TRC 890.3850 IOR TISPORT, LLC TRC NA

    Patients

    Seq Age Sex Outcome Treatment
    1 35 YR Required Intervention