BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MAGIC MOBILITY

    MDR report key: 7959025 · Received October 11, 2018

    Report

    Report Number
    3003650116-2018-00003
    Event Type
    Malfunction
    Date Received
    October 11, 2018
    Date of Event
    September 17, 2018
    Report Date
    October 12, 2018
    Manufacturer
    MAGIC
    Product Code
    ITI
    PMA / PMN Number
    K030783
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AS
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4).

    Description of Event or Problem · 1

    SMOKE AND SPARKS FROM WHEELCHAIR ARMREST.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    798330 MAGIC MOBILITY FRONTIER ITI MAGIC FRONTIER V6

    Patients

    Seq Age Sex Outcome Treatment
    1 13 YR