inforMED
InjuryIOR

CATALYST 5VX

Received Dec 19, 2022 · Event occurred Sep 18, 2022

Report 3005905321-2022-00002 · MDR key 16008567

Device

Generic name

Mechanical Wheelchair

Manufacturer

Ki Mobility, Llc

Model number

CATALYST 5VX

Product problems

  • Insufficient Device Problem Information
  • Insufficient Device Problem Information

Patient

Unknown

  • Limb Fracture
  • Limb Fracture

Narrative

Additional Manufacturer Narrative

AS OF THE FILING DATE, NO FURTHER INFORMATION HAS BEEN PROVIDED TO KI MOBILITY ON THE ALLEGED INJURY. IT CANNOT BE DETERMINED IF THE DEVICE CONTRIBUTED TO OR CAUSED THE ALLEGED EVENT. DUE TO THE SEVERITY OF THE INJURY, THIS REPORT IS BEING SUBMITTED. IF ANY FURTHER INFORMATION BECOMES AVAILABLE, A FOLLOW UP REPORT WILL BE SUBMITTED.

Description of Event or Problem

END USER WAS REACHING FORWARD FOR ITEM ON THE SHELF AT GOODWILL, HER CHAIR FELL FORWARD WITH HER IN IT. SHE HURT LEFT LEG FOLLOWED UP WITH HER DR. HAS COMPOUND FRACTURE BEING TREATED BY DR.