FDA Adverse Event Other Summary report: N

PRIDE

MDR report key: 1304785 · Received February 3, 2009

Report

Report Number
2530130-2009-00006
Event Type
Other
Date Received
February 3, 2009
Date of Event
January 23, 2009
Report Date
February 3, 2009
Manufacturer
PRIDE MOBILITY PRODUCTS CORPORATION
Product Code
ITI
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
CT, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS BEING RETURNED FOR EVALUATION. CONCLUSION: A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE THE EVALUATION IS COMPLETE.

Description of Event or Problem · 1

THE END USER ALLEGES HIS POWERCHAIR BEGAN TO SMOKE AT THE REAR OF THE UNIT. THE FIRE DEPARTMENT WAS CALLED BECAUSE OF THE SMOKE. NO INJURY REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 PRIDE POWERCHAIR ITI PRIDE MOBILITY PRODUCTS CORPORATION JAZZY600 NA

Patients

Seq Age Sex Outcome Treatment
1 NI Life Threatening