BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BREEZY WHEELCHAIR

    MDR report key: 40021 · Received September 17, 1996

    Report

    Report Number
    2082643-1996-00113
    Event Type
    Malfunction
    Date Received
    September 17, 1996
    Date of Event
    September 3, 1996
    Report Date
    September 14, 1996
    Manufacturer
    QUICKIE DESIGNS, INC.
    Product Code
    IOR
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    BZ X-TUBE ASSM 16" X 16" PNTD. DEALER CLAIMS THE X-TUBE IS BROKEN AT THE CENTER BOLT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BREEZY WHEELCHAIR WHEELCHAIR - MECHANICAL IOR QUICKIE DESIGNS, INC. NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other