BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PRIDE SHUTTLE

    MDR report key: 141990 · Received January 8, 1998

    Report

    Report Number
    MW1012758
    Event Type
    Malfunction
    Date Received
    January 8, 1998
    Date of Event
    July 28, 1997
    Report Date
    January 8, 1998
    Manufacturer
    PRIDE HEALTH CARE, INC.
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MI, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    THREE WHEELED SCOOTER SITTING IN BACKROOM NOT PLUGGED IN OR TURNED ON. SCOOTER HAD NOT BEEN USED IN 2-3 MONTHS. SCOOTER IDENTIFIED BY FIRE MARSHALL AND INSURANCE INVESTIGATOR TO BE CAUSE OF CATASTROPHIC HOUSE FIRE. FIRE MARSHALL COULD FIND NO REASON FOR IGNITION. CO THAT INSURED SCOOTER REFUSED TO PAY FOR DAMAGES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRIDE SHUTTLE 3 WHEELED SCOOTER INI PRIDE HEALTH CARE, INC. UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Other