MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-02-10 for PERMOBIL M3 CORPUS POWER WHEELCHAIR M3 BASE CORPUS M3 MPO manufactured by Permobil, Inc..
[178961052]
Patient was in the process of reclining his permobil m3 corpus power wheelchair and while he was reclined the back of the chair fell off and the patient was ejected out of the chair. Patient then had increased pain saw his orthopedic surgeon who ordered mris and x-rays. Since that time he has had more difficulty with his bowel program. Fda safety report id # (b)(4). Fda received date: 02/06/2020.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW5092890 |
| MDR Report Key | 9693725 |
| Date Received | 2020-02-10 |
| Date of Report | 2020-02-06 |
| Date of Event | 2019-06-02 |
| Date Added to Maude | 2020-02-11 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | PERMOBIL M3 CORPUS POWER WHEELCHAIR |
| Generic Name | WHEELCHAIR, POWERED |
| Product Code | ITI |
| Date Received | 2020-02-10 |
| Model Number | M3 BASE CORPUS M3 MPO |
| Operator | LAY USER/PATIENT |
| Device Availability | Y |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | PERMOBIL, INC. |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2020-02-10 |