MAUDE Adverse Event Report: QUICKIE/MOTION CONCEPTS POWER WHEELCHAIR

Device Problem Mechanics Altered (2984)

Patient Problem Emotional Changes (1831)

Event Date 10/18/2015

Event Type  Injury  

Event Description

I recently ((b)(6) 2015) got a new power chair with a tilt feature for pressure release.On (b)(6), while in full tilt recline the chair would not release and return to an upright position.It was about 11 pm and my first action was to call the company that sold me the chair.I contacted a rep who tried to help to no avail.She had a tech call me and again the tech was not able to give me any advice as to how to resolve my issue.My wife and daughter were with me and luckily they were able to undo the wheel stop, bring me next to my bed and physically lift me out of the chair.This was not an easy process, my daughter is a physical therapist and at least had the knowledge to know how to lift me safely.If i had been alone or with just my wife i would have to, have called 911.This type of chair needs a manual, mechanical release in case of electronic/computer break downs.This chair could have caused me serious physical injury breaking down in the full tilt position.As it is i have had several nights of nightmares, as the hour or so that i was stuck in the chair was quite nerve wracking.

• Brand Name: POWER WHEELCHAIR
• Type of Device: POWER WHEELCHAIR
• Manufacturer (Section D): QUICKIE/MOTION CONCEPTS
• MDR Report Key: 5187441
• MDR Text Key: 29941773
• Report Number: MW5057503
• Device Sequence Number: 1
• Product Code: ITI
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Patient
• Type of Report: Initial
• Report Date: 10/26/2015

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 10/26/2015
• Is this an Adverse Event Report?: Yes
• Is this a Product Problem Report?: Yes
• Device Operator: Lay User/Patient
• Type of Device Usage: N
• Patient Sequence Number: 1
• Patient Outcome(s): Required Intervention
• Patient Age: 61 YR
• Patient Weight: 100