BEUDAMED
    FDA Adverse Event Death Summary report: N

    BOUNDER PLUS

    MDR report key: 191627 · Received October 10, 1998

    Report

    Report Number
    2027797-1998-00001
    Event Type
    Death
    Date Received
    October 10, 1998
    Date of Event
    September 1, 1998
    Report Date
    October 9, 1998
    Manufacturer
    21ST CENTURY SCIENTIFIC, INC.
    Product Code
    ITI
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    USER FELL BACKWARDS OFF OF A VAN LIFT WHILE IN A BOUNDER PLUS POWER WHEELCHAIR. FURTHER DETAILS AND CAUSE OF ACCIDENT ARE UNKNOWN AT THIS TIME.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BOUNDER PLUS POWER WHEELCHAIR ITI 21ST CENTURY SCIENTIFIC, INC. BOUNDER PLUS *

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Death