BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    P300 (20") POWER WHEELCHAIR

    MDR report key: 79446 · Received March 27, 1997

    Report

    Report Number
    2082643-1997-00437
    Event Type
    Malfunction
    Date Received
    March 27, 1997
    Date of Event
    March 14, 1997
    Report Date
    March 26, 1997
    Manufacturer
    QUICKIE DESIGNS, INC.
    Product Code
    ITI
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    8 X 2 FORK/STEM WITH HDWR P3. DEALER CLAIMS FORK STEM BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 P300 (20") POWER WHEELCHAIR WHEELCHAIR, POWERED ITI QUICKIE DESIGNS, INC. NA P/N-929920

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN Other