MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; TRANS CHAIR,ALUM,12 WHL, 19" 300 LB, RED

Catalog Number	MDS808210ARE
Medical Device Problem Codes	Mechanical Jam (2983); Activation Failure (3270)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	12/12/2025
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that brakes are pushed against the wheels and can feel it rubbing.Customer also mentioned you cannot pull it down or up to engage.
Additional Manufacturer Narrative
Per call customer informed brakes are pushed against the wheels and can feel it rubbing, and customer mentioned you cannot pull it down or up to engage; no injury or fall reported.Sample and/or photo provided: not available; finished good/component trending performed: yes; quality control inspections records reviewed: yes.Investigation results: not confirmed.Sample required to determine cause; no trends were identified for the specified material number and its corresponding defect type, the serial number passed inspection, and the division will monitor complaints through quarterly trending.There were no reports of death, serious injury, medical intervention, or follow up care.It has been determined that the reported event could cause or contribute to serious injury if it were to occur again.In an abundance of caution, this is a reportable event.If additional information becomes available this report will be reopened and reevaluated.This medical device report (mdr) is being submitted as part of retrospective review activities, which include review of historical data in accordance with regulations at 21 cfr part 803.The information included in this mdr reflects the information reasonably known to the manufacturer at the time of this retrospective review and submission.

• Brand Name: MEDLINE
• Common Device Name: TRANS CHAIR,ALUM,12 WHL, 19" 300 LB, RED
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield IL 60093
• Manufacturer Contact: william abrams ; three lakes drive; northfield, IL 60093
• MDR Report Key: 50945368
• Report Number: 1417592-2026-54064
• Device Sequence Number: 9534615
• Product Code: INM
• UDI-Device Identifier: 40884389150819
• UDI-Public: 40884389150819
• Combination Product (Y/N): N
• Initial Reporter State: FL
• Initial Reporter Country: US
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Type of Report: Initial
• Report Date (Section B): 09/28/2026

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Catalogue Number: MDS808210ARE
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 12/12/2025
• Initial Report FDA Received Date: 09/30/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Is the Device Labeled for Single Use? (Y/N): No
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Initial
• Patient Sequence Number: 1
• Patient Sex: Unknown