BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    QUICKIE REVOLUTION WHEELCHAIR

    MDR report key: 178635 · Received July 24, 1998

    Report

    Report Number
    2082643-1998-00957
    Event Type
    Malfunction
    Date Received
    July 24, 1998
    Date of Event
    July 23, 1998
    Report Date
    July 24, 1998
    Manufacturer
    SUNRISE MEDICAL MPD
    Product Code
    IOR
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    REPORTER CLAIMS THE BACK FRAME BROKE WHILE CHAIR WAS IN USE. NO INJURIES INVOLVED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 QUICKIE REVOLUTION WHEELCHAIR WHEELCHAIR MECHANICAL IOR SUNRISE MEDICAL MPD NA P/N-840168

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR Other