BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HOVEROUND CORPORATION

    MDR report key: 1151400 · Received September 4, 2008

    Report

    Report Number
    1056601-2008-00022
    Event Type
    Injury
    Date Received
    September 4, 2008
    Date of Event
    July 15, 2008
    Report Date
    September 3, 2008
    Manufacturer
    HOVEROUND CORPORATION
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    NO MALFUNCTION OF MOTORIZED WHEELCHAIR SUSPECTED. THE POLICE REPORT STATES THAT END USER WAS OPERATING THE POWER WHEELCHAIR IN THE ROADWAY, AGAINST TRAFFIC AND DID NOT STOP BEFORE CROSSING THE INTERSECTION. THE OWNER'S MANUAL WARNS, "DO NOT DRIVE YOUR MPV 4 ON THE ROADWAY OR PUBLIC STREETS".

    Description of Event or Problem · 1

    ACCORDING TO THE POLICE REPORT THE END USER WAS OPERATING THE MOTORIZED WHEELCHAIR IN THE ROADWAY AND WAS STUCK BY A MOTOR VEHICLE WHILE ATTEMPTING TO CROSS THE ROADWAY. ALLEGEDLY, AS A RESULT OF THE INCIDENT, THE END USER REQUIRED HOSPITALIZATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HOVEROUND CORPORATION MOTORIZED WHEELCHAIR ITI HOVEROUND CORPORATION MPV4

    Patients

    Seq Age Sex Outcome Treatment
    1 54 YR Hospitalization