BEUDAMED
    FDA Adverse Event Other Summary report: N

    LIBERTY 624EZ

    MDR report key: 2923339 · Received October 2, 2006

    Report

    Report Number
    1065497-2006-00001
    Event Type
    Other
    Date Received
    October 2, 2006
    Date of Event
    September 11, 2006
    Report Date
    September 28, 2006
    Manufacturer
    EAGLE PRODUCTS
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    UPON INITIAL INSPECTION IT WAS DETERMINED THE ORIGINAL MANUFACTURES BATTERY HARDWARE HAD BEEN CHANGED, WHEN THE BATTERIES WERE RECENTLY REPLACED BY DEALER. THE BOLTS THAT WERE USED FOR THE CONNECTION OF THE TERMINALS WERE TOO LONG AND INSTALLED BACKWARDS. THIS ALLOWED THE BATTERY POST TO COME INTO CONTACT WITH FRAME OF THE CHAIR. WHEN THIS OCCURRED THE BATTERY ARCED AND WELDED THE BATTERY POST HARDWARE TO THE FRAME OF THE CHAIR. THIS ALLOWED THE BATTERY TO OVERHEAT AND IGNITE CAUSING THE CHAIR TO CATCH ON FIRE. THIS CHAIR HAS BEEN IN USE 1 YEAR AND 2 MONTHS PRIOR TO THIS INCIDENT. THERE IS NO HISTORY OR EVIDENCE TO SUGGEST A PRODUCT PROBLEM OR MALFUNCTION. THE MANUFACTURER VIEWS THIS AS A DEALER/SERVICE ERROR.

    Description of Event or Problem · 1

    THE CUSTOMER WAS USING HIS POWER WHEELCHAIR OUTDOORS, WHEN HE SAW SPARKS COMING FROM UNDERNEATH HIS CHAIR. HE WAS ABLE TO GET OUT OF THE CHAIR AND AFTER, THE CHAIR CAUGHT ON FIRE AND BURNED COMPLETELY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 LIBERTY 624EZ WHEELCHAIR ITI EAGLE PRODUCTS 624EZ

    Patients

    Seq Age Sex Outcome Treatment
    1 82 YR Other