BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    P300 POWER WHEELCHAIR

    MDR report key: 78663 · Received March 25, 1997

    Report

    Report Number
    2082643-1997-00415
    Event Type
    Malfunction
    Date Received
    March 25, 1997
    Date of Event
    March 10, 1997
    Report Date
    March 25, 1997
    Manufacturer
    QUICKIE DESIGNS, INC.
    Product Code
    ITI
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CASTER STEM PWR THICK. DEALER CALIMS FORK STEM BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 P300 POWER WHEELCHAIR WHEELCHAIR, POWERED ITI QUICKIE DESIGNS, INC. NA P/N-481110

    Patients

    Seq Age Sex Outcome Treatment
    1 36 YR Other