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Saturday, October 12, 2013

Wheelchair Industry: A History Lesson and Defeating Reality


My wheelchair frame is old. I am guessing it is at least 20 years old. As of today, I have two wheelchair frames. A third frame was retired a few years ago. The frames have worked wonderfully for me. The frames have one drawback:  they are heavy. Really heavy. This was never an issue. I wanted a wheelchair that suited my lifestyle. It had to take abuse and operate flawlessly in all weather conditions. Routine problems such as flat tires had to be easy to repair. It needed parts I could find them at any hardware or bike store in the world. I regularly change the upholstery and tires. Every five years or so I have the frame powder coated.  Major problems had to be possible to resolve. For example, many years ago Northwest Airlines cracked the frame. I vigorously complained and insisted the frame be repaired. Hours later I had it welded back together in an obscure jet hanger in Detroit. While the frame was repaired I had a nice chat with a mechanic who told me the airline routinely breaks even the hardiest products in its cargo holds. 

In recent years my life style has changed. I am settling into middles age. Sigh. I do not travel as much and when I do it is from one airport hub to another. I am active but in a middle aged way. I do not take stupid risks assuming all will be well. More to the point, my wheelchair is heavy and is at this point verging on too heavy. In short, I need a I need a new wheelchair. I have been searching for a good wheelchair for the last two years. My search has reminded me why I despise wheelchair manufacturers. One can purchase a slew of inferior wheelchairs for thousands of dollars. My needs are simple: I want a wheelchair that is light and tough. I want excellent wheels and the best hubs money can buy. This presents a multitude of problems. Wheelchairs are not made to last more than a few years. The wheelchair industry is dominated by one company--Quickie. The Quickie corporate entity Sunrise Medical is the modern day equivalent of Everest & Jennings that once enjoyed a monopoly on wheelchair manufacturing. The mere mention of E&J decades after they went out of business still prompts me to utter a string of curse words. E&J was despicable company. Sunrise Medical is not much different. I see lots of Quickie wheelchairs in various states of disrepair. I am not at all impressed. They have a lego approach to wheelchair building. They use the same parts on all the wheelchairs manufactured. The designs are periodically changed but there is one constant: they are poorly designed and fall apart after a few years of use. I would rather crawl than buy a Quickie wheelchair. 

Plenty of small companies manufacture wheelchairs. They eek out an existence in the shadow of the giant Sunrise Medical. Some small companies make a profit and cater to specific clients. The current climate in the wheelchair industry reminds me of the late 1970s and early 1980s when the E&J monopoly was busted by the Department of Justice. Every paralyzed person I knew back then despised E&J. If my memory is correct my first few wheelchairs were  E&J Stainless steel sport. These wheelchairs weighed about 50 pounds and screamed danger, sick person present. Worse, these wheelchairs were designed to be used indoors by an elderly person and could not be purchased without a physician’s approval. E&J wheelchairs were substandard at best. E&J wheelchairs had not changed for decades. Wheelchairs were literally a cash cow. E&J knowingly and willfully stymied any attempt at innovation.  One could fold an E&J wheelchair but the frame was very weak. When a frame cracked, as they routinely did, E&J considered going up or down a curb and many other routine activities "abusive". I went through a lot of wheelchairs. Worse, the people that worked for E&J were condescending and rude. Thanks to the Department of Justice, social and legal advances, and decades of angry customers a revolution took place in wheelchair manufacturing. The rigid frame was invented. Power wheelchairs were also invented at this time but that is a very different story. 

Rigid frame wheelchairs originated in California. People with a SCI for the first time in history were not only surviving but thriving. The Vietnam War certainly was a major variable as was the fact spinal cord injury was the signature would of that war. A critical mass of pissed off paralyzed people had been obtained. With nowhere to turn paralyzed men and women started to experiment.  Lots of people began to make wheelchairs that were sturdy and could withstand the rigors of a typical life. People began to borrow ideas from the aviation, motor cycle, and bicycle industry. Fabricators got involved as did various industrial designers. Within a few years rigid framed wheelchairs developed a cult like following. People had heard about the rigid frames and the cool factor was off the chart. Keep in mind back then there was no such thing as the internet.  Adaptive sports consisted of wheelchair basketball. Wheelchair basketball and tennis wheelchairs did not exist. Sit skis did not exist. No one thought of making a well designed wheelchair for a specific sport or purpose. Paralysis, people assumed, precluded involvement in sports and an active life.   

Rigid frame wheelchairs were not mass produced in the late 1970s and early 1980s. They were made one by one. They were made largely by paralyzed people in their garages. Some were made by physical or recreational therapists who became friends with paralyzed people. The people that made rigid frame wheelchairs also sold and marketed their product. The market was friends and friends of friends. It was not unusual circa 1980 in California for a person to show up at the door of a person that made rigid frame wheelchairs and ask for one to be made.  Why were people so excited? Rigid frame wheelchairs do not break. Welds held up under rigorous use. A host of colors were available for the first time. Wheels and hubs were of high quality. Quick release hubs were utilized. All this is commonplace today but back in the day this blew people’s mind. It blew my mind. A wheelchair that did not break, came in any color I wanted, and could last a long time. 

Dozens of companies popped up. Bob Vogel has written about the origins of the rigid frame in California. Graham Pullin touches upon the subject in in his book Design Meets Disability. At first glance, a wheelchair appears to be simple. Four wheels and a seat. The fact is making a durable, tough, and light weight wheelchair is exceedingly complex and requires technological sophistication in multiple fields. Radical innovation is also not easy to see. Instead, radical innovation is felt by the user. Such innovation is costly and dependent upon the durable medical goods industry. Another significant variable is wheelchairs are manufactured for what health insurance companies are willing to cover. The same problem exists in adaptive sports. Hand cycles, sit skis, basketball and tennis wheelchairs are made to meet the needs of adaptive sport programs not the athletes themselves. The result is a limited number of spectacular and empowering products have recently emerged that no one can afford.  

Last summer I tried the Panthera X. The wheelchair in my estimation is the first radical leap forward in wheelchair design since 1980. The wheelchair is deceptively simple. It is an elegant design that took years and millions of dollars to create. The Panthera X is marketed as the lightest rigid frame wheelchair in the world. I took it for a quick spin around a parking lot and was flabbergasted. The wheelchair weighs 9.7 pounds and the frame is made of carbon fiber. The down side is the price. It costs in excess of $10,000. All its parts are proprietary. Thus if any part of the wheelchair breaks life will come to a sudden and dramatic halt. A person needs to shell out $10,000 and have an operational wheelchair in reserve. The Panthera X wheelchair cannot be insured. I would have serious concerns about getting on an airplane with an uninsured $10,000 wheelchair. This makes no sense. You can insure a car and a cell phone but you cannot insure a wheelchair. And more to the point, how many people can shell out this sort of money when70% of people who are disabled are unemployed. But what the heck--the cool factor is off the chart. 


Let's put this in perspective. The above massively cool life altering Panthera X wheelchair costs in excess of $10,000. The Nissan Versa 1.6 costs $9,999 brand new.


A car costs as much as a manual wheelchair? Really? Do not get me wrong. The Panthera X is an amazing wheelchair. I am sure about 1,000 people in the United States are going to be thrilled with this wheelchair. That leaves several million other paralyzed people that will move on with inferior short lived wheelchairs made by Quickie. This makes no sense. But I have a dream. In order to empower paralyzed people here is what I think should be done. If appropriate purchase a Panthera X for a paralyzed person. Give a person 6 months of intense rehabilitation. Give a person his choice of a handcycle or sit ski. Give this person two years worth of lessons at adaptive sports centers. Send this person to college or place them in a work study program. Have a job placement office at the rehabilitation center. Finally give this person a life time supply of wheelchair cushions and urological supplies. Sound expensive? You bet. And there is not a doubt in my mind this would save hundreds of millions of dollars. Imagine if it reduced the unemployment rate among people with a disability from 70% to 20% That would mean 80% of people with a disability would be working and paying tax. There would be a demand for accessible housing and transportation. The world would be a better place. Lives would be saved. And sadly I am dreaming. It ain't never gonna happen.     

24 comments:

jen4whln said...

I have had 5 chairs, 4 which were Quickies. My favorite chair was a Kuschall. It fit me perfectly. I never had issues with leg spasms or other bodily discomforts. Sadly, the Kusch all is only made over seas and can no longer be purchased here in the states. Presently, my chair is a Q7, from Quickie. I only wish I could get another Kuschall.

william Peace said...

Jen, This is exactly the problem. In the last 25 years I have not replaced a wheelchair frame. Why did you replace the Quickies? I cannot tell you how many times I have literally seen parts fall off a quickie and the person using it keep on going with a shrug. Makes no sense to me.

Matthew Smith said...

The name Quickie really sounds like a reflection of the manner of its construction! The name was chosen by the woman who founded the company (before it was taken over by Sunrise) because it sounds fun, supposedly, but it makes it sound shoddy.

Katja said...

The other problem with the Panthera X is the limited sizes.

Have you considered either having either Mike Box or Lasher do something Panthera X-like for you? It would probably cost less, and you could get the sizing exact.

I'm currently in an Icon, after 10 years in a Top End Terminator. We'll see how it holds up. Jeff Adams & company are very responsive to their customers

william Peace said...

Katja The panthra is problematic in terms of size. Clearly they are designed for slender people. Mike Box is supposedly good but I have never seen one on the east coast. The price is way less. Lasher is ok. Icon is good but heavy.

Katja said...

Icon is heavier than the Panthera X, for sure, but pretty much every other chair out there is as well. My Icon weighs in almost exactly the same as my TE Terminator Titanium (whose frame, BTW, is still perfect, despite rough handling and a few embarrassing drops).

william Peace said...

Katja, Icon is a funky chair. The construction and materials are weird to me. I can see the appeal. I bet they can take a beating. My latest idea is to hire a fabricator and have my current frame modified slightly but made of titanium.

Katja said...

It's an aluminum frame, but yes, it is funky, and it takes the eye a little while to appreciate it. I went for it because I wanted suspension without a big weight and cost penalty, and because I wanted to be able to modify dimensions and angles (again without a big weight penalty). I hope your frame fabrication plan works out!

Stephen said...

As someone who been selling wheelchairs, I never get requests for Quickies. As you note, they have a lousy reputation. They make up a tiny percentage of the chairs I see folks using here in NYC, and I know and see lots of folks in chairs.

The greatest demand I get is for TiLite, which is also, by far, the most common ride here in the East.

Oracing, a Spanish manufacturer, makes superior chairs but they are not yet FDA approved, so are not available here in the US. Hopefully soon. They're great in that as a small company they'll build pretty much any design you can conceive and they don't gouge their customers for going off the menu. Check out their Facebook page and ample photo gallery.(Armed with a Canadian shipping address, you're close enough in Syracuse to drive across the border to pick one up.)

william Peace said...

Stephen, No doubt you know the wheeIchair market better than me. I too see a lot of TiLite wheelchairs in NYC. I also see Quickies often with parts falling off. The TilLite is about the best one could hope to afford. It is better than Quickie but that is setting the bar very low indeed. What do you think of Mike Box? I have never seen one.

Bo Lorentzen said...

William, great post.

I keep thinking there is a need for a open-source chair, parts kits that users can purchase at a cost base.

I could easily imagine a control kit for a chair, with a parts list that in the end will build a great budget chair.

william Peace said...

Bo, I get the point you are trying to make r.e. parts to wheelchairs. Clearly, you are building on the concept of universal design. I joke that universal design is universally inconvenient for all. As I see it, the real problem with obtaining parts to wheelchairs manufactured today are proprietary parts. I first saw this in cars and it has spread to many other manufactures. Panthera is not an American based company. So if the brakes on the wheelchair fail it is not as though you go to hardware store or even the dealer that sold the wheelchair. How many people can spend $10,000 on a wheelchair and to be cautious spend thousands more on parts likely to break. This is a huge problem.

Jo Kelly said...

I hate Quickies too!

Bill check out RGK - they are great chairs! My frame is going on 12 years now and it's holding up fabulously. I have replaced the wheels, castors and upholstery once. I think I will die using this chair. You may like it - try the titanium for ultra light weight.

A said...

I'm glad to read all these suggestions--my daughter has a very old beat up Swedish titanium chair that can't really support her seating needs, and a very old custom aluminum chair called an XL, made by a small manufacturer in California that I think isn't in business anymore. It is so disappointing that all these years later, there's still nothing wonderfully new and innovative for her. She can't operate the chair herself, but I just want a lightweight frame, shocks for rough ground, good adjustable seating, swingaway footrests, brake controls on the handles so we're safe going downhill---such perfectly reasonable things, yet not easy to put together. Absurdly hard to put together, actually.

william Peace said...

A. XL went out of business a while ago. They were not bad. I will readily acknowledge making a good wheelchair is exceptionally difficult but it is possible. There are reasons why good wheelchairs are not being designed, built, and sold. This is worthy of intense discussion. I just do not know how to generate such a discussion.

A said...

I agree it's worthy of ongoing discussion---why is this field so immune to consumer desires and market forces?

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YankeeEsq said...

I have had a TiLite for 6 years. I'm 245 lbs, live in Brooklyn, and chase my two young sons all around Brooklyn in it (with a Freewheel in front which has bordered on life-changing in allowing me to easily cruise across grass, survive snow, & double my speed to keep up with them over crappy sidewalks).

Would like a lighter chair, but this has been really durable. Knock wood, I cracked an axle once, but the frame has held up fine.

I had a Kuschall and while it was great while it worked, I cracked the carbon composite of the folding front regularly and was on a first name basis with their office staff for replacements. I know that welding titanium would be an issue, but I won't be a first adopter of a carbon fiber chair. Fingers crossed it gets figured out and costs come down before my joints totally crap out (which is of course happening). Tripple the price of titanium is too hard to justify (much less afford).

william Peace said...

YankeeEsq, I am glad your wheelchair works well for you especially given you weight 245. Durability as you noted is key. An unreliable wheelchair is a nightmare. I remember those Kuschall wheelchairs. The folding back breaking was a design flaw. And the key yo your comment--cost. Both manual and power chairs are the most overpriced product sold. I find this unacceptable given that a wheelchair is essential for navigating the world.

BotanyBay said...

I sit her in my Quickie GP, just read your blog, and now I'm pissed. In the last year I've spent just over 1100.00 just for parts. Right this very moment, my right axle plate is on verge of shearing right off, honestly I can't complain, the chair is 14 years old. Am guessing chairs don't last forever. What really ticked me off is the quality or lack there of ...of the parts themselves, the axle sleeve, nuts and washers are stainless steel, yet the axle plates look to be pot metal. Half tempted to take new parts to machine shop and ask some guy to cut the new axle plates out of SS too. Anyway, I did appreciate the info contained in this blog. I am ranting now, just wish there were a company out there that could build a quality wheel chair and parts at a cost we could afford.

Prof. C said...

Hi William -- I'm trying to replace the TiLIte I got via Medicare 2 1/2 years ago. Still switching back & forth to my Bob Halls chair, which was amazing but is a little too small for me (even so I used it for 12 years). For those considering a TiLite, try to avoid the adjustable front caster system -- it really is a crucial design flaw and has caused me a great deal of stress. (Casters get pushed out of alignment, and the screws to hold them in place get stripped, so you end up with the "broken shopping cart" syndrome. Aside from reminding one of bad comedians, it can be dangerous and wreak havoc with your shoulders. At least it is with mine (plus the chair is heavier than it should be, IMHO.)

Searching now for a new rig, almost went with one place but they screwed the pooch on building an analog of the Halls chair. I'm also in NYC -- if you are around and would like to chat I'd love to talk further. Bcostellonyc@gmail.com works (I think I'm logged in with a work email on this site - that'll work too).

Gigi Steyer said...

Hello, this is my first post here. I hope this is OK to do. I am a wheelchair user, although I am not permanently disabled. The question I have is, has anyone ever had experience with using a chair that has had a complete break in the frame, and then had it welded, and continued using it? Here's the scenario: I have been using a wheelchair for about 12 years, because my condition (CRPS, which I also call "the Star Trek disease") is very difficult to rehab from, especially while raising twins, who just turned thirteen. About 4 1/2 years ago, we purchased a Colours Razorblade, which was my first rigid frame wheelchair. I needed to be able to get it in and out of the car (a Nissan Leaf) myself. Because I am not paralyzed, and because it made it easier for me to get in and out of the chair, we took off the footplate. You see, I "crawl" into the chair from the ground, on kneepads, because I cannot bear weight through my feet yet. Well, the way I was getting the chair into the car was, I tipped it forward (onto the frame posts that used to hold the footplate) and rested the back of the chair on the armrest of my car door, in order to get the wheels off. Recently, I noticed that the bar that goes across under the seat was severed at one of the joints, making the chair extremely unstable, and, in my opinion, unsafe. Although the frame was supposedly guaranteed for life, because this is not considered a manufacturer defect, the mfg. won't replace it. The technician at my wheelchair place says the break was most likely caused by the combination of not having the footplate on there, and my method of getting it into the car, which created a sheer force that ultimately led to the frame cracking over time. My husband (who is NOT a wheelchair user, but is generally a good guy), is very cranky because he feels that since we paid a little over $2,000.00 for this chair (it was a floor model, so was cheaper than custom) it should last close to forever. He also thinks that the dealer is just trying to cheat us, and that they are trying to take advantage of me since I'm in a wheelchair! He feels that we should get the frame welded, although I have no idea where one would go for that (we live in the San Francisco Bay Area). I feel very uncomfortable with the idea of a sitting on a frame that has been welded, plus, I'm still going to be getting the chair in and out of the car the same way, which will only lead to it cracking again. Oh, and we can't just put the footplate back on - the frame posts have been, shall we say, "sanded down" by the concrete over time, and now you can't re-attach the plate. Actually, if you ask me, the chair is fairly trashed (OK, I am kind of hard on things, so it's probably, in the end, my fault). The dealer I go to has a new floor model of a TiLite 2GX that fits me like a charm, (I have really long legs) and I can get it for the same price we paid for the Razor. It's perfect in every way! So light, footrests come off (ideal), folds up, easy to get in the car without compromising the chair. I think if I was going to be in a chair for life, maybe my husband wouldn't be so against it. But still, I might be looking at at least 18-24 more months of being in a chair, and that's IF I don't have anymore setbacks. Plus, even when I'm out of the chair, I wouldn't ever get rid of it. With CRPS, flares can always come back, and I could be back in it again someday. So, I'd like to stay safe during the remaining rehab time I have. Has anyone on this list ever had experience with using a chair that had it's frame welded? I'd like to get an impartial opinion from someone who isn't going to profit from the outcome of the decision!
Thanks so much, and sorry this is so long. Gigi

Randy MacMillan said...

Hi William. Thanks for the details about the Panthera X. I am a biased person as my company distributes the Panthera line of wheelchairs for USA and Canada. Firstly the Panthera X has been a life changing product for users who can afford it and those who get it funded. Veterans Affairs now regularly approves the Panthera X for purchase. Sizing has not been a problem because it is available in 13" to 18" widths and 15 different backrest heights and the frame can be reinforced for users as large as 300 lbs. One veteran from the Northwest area received a Panthera X 4 years ago after having shoulder surgery 2 times. His therapist was starting to recommend power assist products and even a power chair. For him this would negatively change his life as he was always so active. Since having the Panthera X he has mantained his activity and no longer experiences shoulder pain from transfer and propulsion. In 4 years he has never replaced the brakes, however, he has replaced the casters 3 times and replaced the rubber tires many times as he prefers the Schwalbe Ultremo slicks and the airline bent one of his front forks which we had in stock and replaced right away. Yes Pantjera uses proprietary parts but you must understand this was necessary to make the parts lighter and better which is further to the point several people mention about inferior parts. This veteran says the Panthera X saved his life and will tell anyone. We have had several private insurance approvals and also we have had several Vocational rehab purchases in a few states and funny enough the last one in Ohklahoma was considered the lowest cost alternative compared to the adaptive van and power assisted manual chair. This user was able to prove she could transfer into her compact car independently with ease with a Panthera X which she could not do with any other brand or model of wheelchair. Soon after she was gainfully employed which is further to you dream of a better world if funding would get out in front of these issues to help disabled people. I am not saying private insurance will pay for the Panthera X but we have success stories and almost all have a great therapist making the case to the insurance company why the Panthera X will save them money. The cost of a shoulder or wrist surgery is far more expensive and takes you out of action for while and if a higher priced wheelchair can defer these wear and tear issues and costs into the future or prevent the more expensive cost of adaptive vehicles and additional power devices and the therapist is good with stating this in a justification letter then there is a chance. It's not only rich people who get the Panthera X I can assure you. I would he happy to discuss this with anyone interested. We have so many life changing stories. If anyone wants to write a new chapter on their wheelchair journey then give me a call. My name is Randy MacMillan and I can be reached at 855-546-0711 X:3 or by email at sales@triumphmobility.com