FDA Adverse Event
Injury
Summary report: N
DRIVE
MDR report key: 15574262
·
Received October 10, 2022
Report
- Report Number
- 2438477-2022-00105
- Event Type
- Injury
- Date Received
- October 10, 2022
- Report Date
- October 10, 2022
- Manufacturer
- LERADO H.K. LTD.
- Product Code
- INI
- UDI-DI
- 00822383991771
- Adverse Event
- Yes
- Product Problem
- Yes
- Report Source
- Distributor report
- Reporter Location
- OH, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 0
DRIVE DEVILBISS HEALTHCARE WAS NOTIFIED OF AN INCIDENT INVOLVING A POWER SCOOTER BY AN END USER'S SISTER, WHO STATED THAT THE END USER "TRIED TO GET ONTO THE SCOOTER AND MUST HAVE TRIED TO HOLD ON BY THE THROTTLE AND IT MOVED ON HER," CAUSING HER TO FALL AND INJURE HER LEG. SHE WAS REPORTEDLY HOSPITALIZED FOR 3 DAYS AND IS NOW UNDERGOING PHYSICAL THERAPY. DRIVE IS CURRENTLY INVESTIGATING THE INCIDENT, INCLUDING ATTEMPTING TO RETRIEVE THE PRODUCT AND INSPECT IT, AND WILL FILE AN UPDATE IF ADDITIONAL INFORMATION BECOMES AVAILABLE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 2800471 | DRIVE | POWER SCOOTER | INI | LERADO H.K. LTD. | SFPRO317FS-21 | 00822383991771 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Female |