BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HOVEROUND CORPORATION

    MDR report key: 1233886 · Received November 13, 2008

    Report

    Report Number
    1056601-2008-00027
    Event Type
    Injury
    Date Received
    November 13, 2008
    Date of Event
    September 15, 2007
    Report Date
    November 10, 2008
    Manufacturer
    HOVEROUND CORP.
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    KY, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    NO MALFUNCTION OF MOTORIZED WHEELCHAIR SUSPECTED. END USER ADVISED THAT SHE MISJUDGED THE DISTANCE OF THE SEATING UPON TRANSFERRING INTO THE MOTORIZED WHEELCHAIR. THE OWNER'S MANUAL WARNS, "THE OPERATION OF THE POWER CHAIR REQUIRES CAUTION AND CONSIDERATION FOR YOUR PERSONAL SAFETY AND THE SAFETY OF OTHERS AROUND YOU".

    Description of Event or Problem · 1

    END USER ALLEGES WHILE TRANSFERRING INTO THE MOTORIZED WHEELCHAIR, SHE MISJUDGED THE SEATING DISTANCE AND FELL TO THE FLOOR, ALLEGEDLY, FRACTURING HER LEFT LEG.

    Devices

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

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Hospitalization| R