BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PRIDE MOBILITY PRODUCTS

    MDR report key: 13230975 · Received January 11, 2022

    Report

    Report Number
    2530130-2022-00004
    Event Type
    Injury
    Date Received
    January 11, 2022
    Date of Event
    August 4, 2021
    Report Date
    January 11, 2022
    Manufacturer
    PRIDE MOBILITY PRODUCTS
    Product Code
    ITI
    PMA / PMN Number
    UKN
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 0

    THE DEVICE HAS NOT BEEN MADE AVAILABLE FOR EVALUATION. SHOULD FURTHER INFORMATION OF THE DEVICE BECOME AVAILABLE, A FOLLOW-UP REPORT WILL BE ISSUED.

    Description of Event or Problem · 0

    RECEIVED LETTER FROM ATTORNEY ALLEGING ON (B)(6) 2021, A WHEELCHAIR BEING OPERATED BY MS. (B)(6) MALFUNCTIONED CAUSING A FIRE IN HER RENTED APARTMENT WHICH RESULTED IN DAMAGE TO HER AND HER PROPERTY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    686643 PRIDE MOBILITY PRODUCTS POWERED WHEELCHAIR ITI PRIDE MOBILITY PRODUCTS UKN N/A

    Patients

    Seq Age Sex Outcome Treatment
    1 Female Hospitalization