BEUDAMED
    FDA Adverse Event Other Summary report: N

    QUICKIE

    MDR report key: 437239 · Received January 10, 2003

    Report

    Report Number
    2082643-2003-00001
    Event Type
    Other
    Date Received
    January 10, 2003
    Date of Event
    September 26, 2002
    Report Date
    January 10, 2003
    Manufacturer
    SUNRISE MEDICAL MPD
    Product Code
    ITI
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE CLIENT REACHED UNDER THE CHAIR WHILE IN THE TILT POSITION TO PLUG IN A CABLE WHICH HAD BECOME UNPLUGGED, AT WHICH TIME THE CHAIR TILTED FORWARD WEDGING THE USER'S ARM. END USER WAS IN THIS POSITION FOR A COUPLE OF HOURS UNTIL THE CAREGIVER ARRIVED AND HELPED THEM OUT. END USER WAS TAKEN TO HOSPITAL BY AMBULANCE FOR X-RAYS AND CAT SCANS. RESULTS ARE STILL UNKNOWN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 QUICKIE WHEELCHAIR, POWERED ITI SUNRISE MEDICAL MPD QUICKIE 5525 P/N MS52

    Patients

    Seq Age Sex Outcome Treatment
    1 61 YR Hospitalization