BEUDAMED
    FDA Adverse Event Other Summary report: N

    PRIDE

    MDR report key: 1171427 · Received September 2, 2008

    Report

    Report Number
    2530130-2008-00015
    Event Type
    Other
    Date Received
    September 2, 2008
    Date of Event
    August 23, 2008
    Report Date
    August 27, 2008
    Manufacturer
    PRIDE MOBILITY PRODUCTS CORP.
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AR, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    DEVICE EVALUATION ANTICIPATED, BUT NOT YET BEGUN. PRIDE IS WAITING FOR THE UNIT TO BE RETURNED FROM THE PROVIDER. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE THE EVALUATION IS COMPLETE. CANNOT DRAW ANY CONCLUSIONS AT THIS TIME.

    Description of Event or Problem · 1

    THE PATIENT ALLEGES SHE WAS IN HER POWERCHAIR WHEN SHE SAW SPARKS AND FLAMES COMING OUT OF THE PORT OF THE JOYSTICK WHERE THE CABLE PLUGS IN. SHE GOT OUT OF THE POWERCHAIR AND CALLED THE FIRE DEPARTMENT. NO INJURY REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRIDE POWERCHAIR ITI PRIDE MOBILITY PRODUCTS CORP. SELECT NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NI Life Threatening