FDA Adverse Event Other Summary report: N

FUZE

MDR report key: 2794754 · Received August 9, 2012

Report

Report Number
9681827-2012-00001
Event Type
Other
Date Received
August 9, 2012
Manufacturer
PDG PRODUCT DESIGN GROUP INC
Product Code
IOR
Product Problem
Yes
Report Source
Manufacturer report

Narratives

Description of Event or Problem · 1

WE SUSPECT THAT THE PDG FUZE WHEEL CHAIRS BUILT IN MAY 2012 MAY HAVE SOME DEFECTIVE HEX BOLTS INSTALLED ON THE LOWER FRAME. THE HEX BOLT HEAD IS GETTING SHEARED AND MIGHT CAUSE THE AXLE PLATE TO DETACH AND IN TURN COLLAPSE THE CHAIR WHEN SOMEONE SITS ON IT. THE FUZE WHEELCHAIRS AFFECTED ARE WITH SERIAL NUMBERS STARTING FROM (B)(4). THE ROOT CAUSE HAS BEEN IDENTIFIED AS A BAD BATCH OF 5/16 HEX BOLTS THAT WAS USED TO BUILD FUZE WHEEL CHAIRS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FUZE FUZE 50 AND FUZE 20 IOR PDG PRODUCT DESIGN GROUP INC

Patients

Seq Age Sex Outcome Treatment
1 Other