FDA Adverse Event Malfunction Summary report: N

QUICKIE 2 WHEELCHAIR

MDR report key: 187950 · Received September 21, 1998

Report

Report Number
2082643-1998-01209
Event Type
Malfunction
Date Received
September 21, 1998
Report Date
September 21, 1998
Manufacturer
SUNRISE MEDICAL MPD
Product Code
IOR
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
SERVICE PERSONNEL

Narratives

Description of Event or Problem · 1

REPORTER CLAIMS X-TUBE BROKE AT THE CENTER BOLT WHILE OPERATOR WAS TRANSFERRING. NO INJURIES INVOLVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 QUICKIE 2 WHEELCHAIR WHEELCHAIR, MECHANICAL IOR SUNRISE MEDICAL MPD NA P/N-672616

Patients

Seq Age Sex Outcome Treatment
1 28 YR Other