WHEELCHAIR SAFETY - ADVERSE REPORTS TO THE UNITED-STATES FOOD-AND-DRUG-ADMINISTRATION

Evidence has been accumulating that injuries related to wheelchair use are common and sometimes serious. The object of this study was to eva luate the databases of the Food and Drug Administration (FDA) for insi ghts to the nature and causes of such problems. We analyzed 651 record s that were received by the FDA between 1975 and 1993. There were 368 injuries, 21 of which were fatal, affecting 334 wheelchair users. Frac tures were the most common (45.5%), with lacerations (22.3%) and contu sions/abrasions (20.1%) accounting for most of the remainder. The prop ortion of incidents related to the use of scooters, powered wheelchair s, and manual wheelchairs were 52.8%, 24.6%, and 22.6%, respectively. Four broad classes of contributing factors, often acting in combinatio n, were implicated: engineering (60.5%), environmental (25.4%), occupa nt (9.6%), and system (4.6%). Of the tips and falls, those in the forw ard direction were most common in incidents affecting manual or powere d wheelchairs, but the sideways direction was most common in scooters. The FDA database provides a unique perspective on wheelchair safety, with implications for clinicians, users, manufacturers, and regulatory bodies.