BEUDAMED
    FDA Adverse Event Other Summary report: N

    CHAIRMAN

    MDR report key: 411156 · Received August 16, 2002

    Report

    Report Number
    1221084-2002-00007
    Event Type
    Other
    Date Received
    August 16, 2002
    Report Date
    August 13, 2002
    Manufacturer
    PERMOBIL AB
    Product Code
    ITI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    MN, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    USER WAS LEANING FORWARD ON THE ARM RESTS OF WHEELCHAIR SEAT. THE ARM RESTS "LET GO" AND PT FELL OUT OF THE SEAT. THE "ARM RAIL" THAT PROVIDES SUPPORT TO THE ARM RESTS IS REPORTED TO HAVE BROKEN AT A WELD, WHICH IS REPORTED TO HAVE BEEN REPAIRED LOCALLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CHAIRMAN POWERED WHEELCHAIR ITI PERMOBIL AB CHAIRMAN 2K *

    Patients

    Seq Age Sex Outcome Treatment
    1 39 YR Other