BEUDAMED
    FDA Adverse Event Other Summary report: N

    CHAIRMAN C2K

    MDR report key: 369682 · Received January 3, 2002

    Report

    Report Number
    1221084-2001-00005
    Event Type
    Other
    Date Received
    January 3, 2002
    Date of Event
    December 24, 2001
    Report Date
    December 27, 2001
    Manufacturer
    PERMOBIL AB
    Product Code
    ITI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Occupation
    NO INFORMATION

    Narratives

    Description of Event or Problem · 1

    USER HAD JUST TRANSFERRED INTO THE CHAIR FROM VEHICLE. AT POWER UP, THE ELEVATING LEG RESTS ACTED ON ITS OWN, TRAPPING USER'S LEGS UNDER THE DOOR OF THE VEHICLE. THE WHEELCHAIR HAD BEEN EXPOSED TO VERY LOW TEMPERATURES FOR AN EXTENDED PERIOD OF TIME (HOURS, NOT DAYS) PRIOR TO THE INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CHAIRMAN C2K POWERED WHEELCHAIR ITI PERMOBIL AB CHAIRMAN C2K *

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO Other