BEUDAMED
    FDA Adverse Event Other Summary report: N

    QUICKIE

    MDR report key: 362308 · Received November 21, 2001

    Report

    Report Number
    2082643-2001-00327
    Event Type
    Other
    Date Received
    November 21, 2001
    Date of Event
    October 22, 2001
    Report Date
    November 21, 2001
    Manufacturer
    SUNRISE MEDICAL, MPD
    Product Code
    ITI
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    RPTR STATES THE REMOTE SHORT-WIRED CAUSING INVOLUNTARY MOVEMENT OF CHAIR WHILE THE END USER WAS SITTING IN IT, IT CHARGED INTO THE REFRIGERATOR ENDING IN A BRUISED ARM.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    52878 QUICKIE WHEELCHAIR, POWERED ITI SUNRISE MEDICAL, MPD QUICKIE S626 P/N 920646

    Patients

    Seq Age Sex Outcome Treatment
    1 21 YR Other