BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    18X18 EVEREST & JENNINGS TRAVELER L4 WHEELCHAIR

    MDR report key: 6857596 · Received September 12, 2017

    Report

    Report Number
    MW5072091
    Event Type
    Malfunction
    Date Received
    September 12, 2017
    Date of Event
    August 30, 2017
    Report Date
    August 31, 2017
    Manufacturer
    GRAHAM-FIELD HEALTH PRODUCTS / EVEREST & JENNINGS INC.
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    LA, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Description of Event or Problem · 0

    PT WAS SITTING IN CHAIR, HEARD A POP, CHAIR OPENED UP AND PT ALMOST FELL TO THE GROUND. PT WAS NOT HURT AND IS FINE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    640271 18X18 EVEREST & JENNINGS TRAVELER L4 WHEELCHAIR WHEELCHAIR IOR GRAHAM-FIELD HEALTH PRODUCTS / EVEREST & JENNINGS INC. 3F030120

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR