FDA Adverse Event
Injury
Summary report: N
DBD-WHEELCHAIR, VINYL, DLR, S/A, K2B, 18
MDR report key: 22055360
·
Received May 20, 2025
Report
- Report Number
- 1417592-2025-00237
- Event Type
- Injury
- Date Received
- May 20, 2025
- Date of Event
- March 25, 2025
- Report Date
- May 20, 2025
- Manufacturer
- MEDLINE INDUSTRIES LP
- Product Code
- IOR
- UDI-DI
- 00884389830041
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 0
IT WAS REPORTED THAT "WHEN SHE WAS ASSISTED TO BE PLACED ON WHEELCHAIR HER FEET SLID AND WHEELCHAIR WENT BACK. IT DID NOT STAY IN PLACE. SHE FELL DOWN AND FRACTURED HER HIP." DUE TO THIS, SURGERY AND THERAPY WAS REQUIRED. IT HAS BEEN DETERMINED THAT THE REPORTED EVENT CAUSED OR CONTRIBUTED TO SERIOUS INJURY, THEREFORE, THIS MEDWATCH IS BEING FILED. IF ANY FURTHER RELEVANT INFORMATION IS IDENTIFIED OR OBTAINED, A SUPPLEMENTAL MEDWATCH WILL BE SUBMITTED.
Description of Event or Problem · 0
WHEELCHAIR NOT LOCKING.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 9597 | DBD-WHEELCHAIR, VINYL, DLR, S/A, K2B, 18 | IOR | MEDLINE INDUSTRIES LP | 00884389830041 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 80 YR | Female | Other |