MATRX-V CUSHION COVER 16W X 16D 9153644815

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2015-09-23 for MATRX-V CUSHION COVER 16W X 16D 9153644815 manufactured by Unknown.

Event Text Entries

[26788726] A follow up will be sent if the product or additional information is obtained.
Patient Sequence No: 1, Text Type: N, H10


[26788727] The dealer stated the matrix back shell cracked.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1525712-2015-04623
MDR Report Key5098505
Date Received2015-09-23
Date of Report2015-08-25
Date Mfgr Received2015-08-25
Date Added to Maude2015-09-23
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationMEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactKEVIN GUYTON
Manufacturer StreetONE INVACARE WAY
Manufacturer CityELYRIA OH 44035
Manufacturer CountryUS
Manufacturer Postal44035
Manufacturer Phone8003336900
Manufacturer G1UNKNOWN
Manufacturer CityOH
Manufacturer CountryUS
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameMATRX-V CUSHION COVER 16W X 16D 9153644815
Generic NameCUSHION, WHEELCHAIR
Product CodeIMP
Date Received2015-09-23
Model NumberMATRX
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerUNKNOWN
Manufacturer AddressOH US


Patients

Patient NumberTreatmentOutcomeDate
10 2015-09-23

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