BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    QUICKIE 2 WHEELCHAIR

    MDR report key: 210389 · Received February 17, 1999

    Report

    Report Number
    2082643-1999-00149
    Event Type
    Malfunction
    Date Received
    February 17, 1999
    Date of Event
    February 16, 1999
    Report Date
    February 17, 1999
    Manufacturer
    SUNRISE MEDICAL MPD
    Product Code
    IOR
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    SERVICE PERSONNEL

    Narratives

    Description of Event or Problem · 1

    REPORTER CLAIMS X-TUBE SNAPPED AT THE CENTER BOLT WHILE CHAIR WAS IN USE. 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-672717

    Patients

    Seq Age Sex Outcome Treatment
    1 38 YR Other