BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BREEZY WHEHELCHAIR

    MDR report key: 80307 · Received March 28, 1997

    Report

    Report Number
    2082643-1997-00466
    Event Type
    Malfunction
    Date Received
    March 28, 1997
    Date of Event
    March 19, 1997
    Report Date
    March 28, 1997
    Manufacturer
    QUICKIE DESIGNS INC.
    Product Code
    IOR
    Removal / Correction Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    Reporter Occupation
    SERVICE PERSONNEL

    Narratives

    Description of Event or Problem · 1

    BZ X-TUBE ASSMN 18" X 16" PNTD. DEALER CLAIMS X-TUBE BROKE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BREEZY WHEHELCHAIR WHEELCHAIR, MECHANICAL IOR QUICKIE DESIGNS INC. NA P/N-673080

    Patients

    Seq Age Sex Outcome Treatment
    1 23 YR Other