BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BREEZY WHEELCHAIR

    MDR report key: 42768 · Received October 17, 1996

    Report

    Report Number
    2082643-1996-00242
    Event Type
    Malfunction
    Date Received
    October 17, 1996
    Date of Event
    September 23, 1996
    Report Date
    October 16, 1996
    Manufacturer
    QUICKIE DESIGNS INC
    Product Code
    IOR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NM, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    BZ X-TUBE ASSEMBLY 18" X 16". DEALER CLAIMS X-TUBE BROKE 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 P/N-673080

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other