BEUDAMED
    FDA Adverse Event Other Summary report: N

    TRACER 5X5

    MDR report key: 759942 · Received September 12, 2006

    Report

    Report Number
    MW1040407
    Event Type
    Other
    Date Received
    September 12, 2006
    Date of Event
    August 7, 2006
    Report Date
    September 1, 2006
    Manufacturer
    INVACARE CORPORATION
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    AR, US
    Reporter Occupation
    PATIENT FAMILY MEMBER OR FRIEND

    Narratives

    Description of Event or Problem · 1

    MY WIFE, WHO IS WHEELCHAIR BOUND DUE TO CEREBELLAR ATROPHY, FELL AGAINST HER WHEELCHAIR (MANUAL FOLDING FROM INVACARE), WHILE TRYING TO SIT DOWN AND CAUGHT HER ARM ON THE FOOT PEDAL UPPER HINGE PIN ON THE LEFT SIDE OF THE WHEELCHAIR AND PUNCTURED AND RIPPED A HALF DOLLAR SIZED WHOLE IN HER ARM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 TRACER 5X5 WHEELCHAIR, FOLDING MANUAL IOR INVACARE CORPORATION 5X5 *

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR Other