BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BREEZY 2 WHEELCHAIR

    MDR report key: 43347 · Received September 24, 1996

    Report

    Report Number
    1524221-1996-00174
    Event Type
    Malfunction
    Date Received
    September 24, 1996
    Date of Event
    September 12, 1996
    Report Date
    September 20, 1996
    Manufacturer
    QUICKIE DESIGNS, INC.
    Product Code
    IOR
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    SERVICE PERSONNEL

    Narratives

    Description of Event or Problem · 1

    BZ X-TUBE ASSEMBLY 18" X 16". DEALER CLAIMS X-TUBE BROKE OF THE CTR BOLT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BREEZY 2 WHEELCHAIR WHEELCHAIR-MECHANCAL IOR QUICKIE DESIGNS, INC. NA NA

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other