BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DRIVE

    MDR report key: 16273308 · Received January 31, 2023

    Report

    Report Number
    2438477-2023-00001
    Event Type
    Malfunction
    Date Received
    January 31, 2023
    Date of Event
    December 23, 2022
    Report Date
    January 30, 2023
    Manufacturer
    GUANGDONG PRESTIGE TECHNOLOGY CO., LTD.
    Product Code
    INI
    UDI-DI
    00822383927350
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    SC, 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, WHO STATED THAT "HIS SCOOTER WAS ON HIS FRONT PORCH AND CAUGHT FIRE ONE AFTERNOON. THE FIRE DEPARTMENT HAD TO COME AND PUT THE FIRE OUT." THE END USER ALSO STATED THAT "THE SCOOTER WAS NOT CHARGING OR PLUGGED INTO AN OUTLET." THERE WAS NO REPORT OR EVIDENCE OF ILLNESS, INJURY OR MEDICAL TREATMENT ASSOCIATED WITH THE COMPLAINT. THERE WAS NO INFORMATION REGARDING WHETHER THE END USER WAS STORING HIS SCOOTER OUTDOORS ON A REGULAR BASIS. 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
    897023 DRIVE POWER SCOOTER INI GUANGDONG PRESTIGE TECHNOLOGY CO., LTD. FLEX-AUTO 00822383927350

    Patients

    Seq Age Sex Outcome Treatment
    1 87 YR Male