BEUDAMED
    FDA Adverse Event Other Summary report: N

    PRIDE

    MDR report key: 1242973 · Received November 24, 2008

    Report

    Report Number
    2530130-2008-00030
    Event Type
    Other
    Date Received
    November 24, 2008
    Date of Event
    November 10, 2008
    Report Date
    November 11, 2008
    Manufacturer
    PRIDE MOBILITY PRODUCTS CORPORATION
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE WAS RETURNED TO PRIDE ON 11/19/2008 FOR EVALUATION. THE DEVICE IS CURRENTLY BEING EVALUATED. A FOLLOW-UP REPORT WILL BE SUBMITTED UPON COMPLETION OF EVALUATION.

    Description of Event or Problem · 1

    RECEIVED A CALL FROM A PRIDE REPRESENTATIVE THAT A CUSTOMER REPORTED HER POWERCHAIR CAUGHT FIRE. THE FIRE WAS EXTINGUISHED. NO INJURY OR PROPERTY DAMAGE WAS REPORTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRIDE POWERCHAIR ITI PRIDE MOBILITY PRODUCTS CORPORATION SELCT 14XL NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NI Life Threatening