BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    DRIVE

    MDR report key: 17086552 · Received June 8, 2023

    Report

    Report Number
    2438477-2023-00055
    Event Type
    Malfunction
    Date Received
    June 8, 2023
    Report Date
    June 8, 2023
    Manufacturer
    WU'S TECH CO., LTD.
    Product Code
    ITI
    UDI-DI
    00822383579559
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    IL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 0

    DRIVE DEVILBISS HEALTHCARE WAS NOTIFIED OF A COMPLAINT REGARDING A MOTORIZED SCOOTER'S BATTERY CHARGER BY AN END USER, WHO STATED THAT HE "HE PLUGGED THE CHARGER INTO THE WALL CONNECTED TO THE SCOOTER, AND AN ELECTRICAL FIRE STARTED." THERE WAS NO REPORT OR EVIDENCE OF ILLNESS, INJURY OR MEDICAL TREATMENT ASSOCIATED WITH THE COMPLAINT. THE END USER ALSO CONFIRMED THAT THERE WAS NO PROPERTY DAMAGE ASSOCIATED WITH THE INCIDENT. HE DID NOT PROVIDE ANY INFORMATION REGARDING THE OUTLET INVOLVED IN THE INCIDENT. DRIVE WILL NOT BE ABLE TO PERFORM A PRODUCT EVALUATION, AS THE END USER CONFIRMED THAT HE DISPOSED OF THE CHARGER FOLLOWING THE INCIDENT. DRIVE WILL CONTINUE TO MONITOR COMPLAINTS FOR ANY RELATED TRENDS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1428025 DRIVE POWERED WHEELCHAIR ITI WU'S TECH CO., LTD. PHOENIXHD4-20 00822383579559

    Patients

    Seq Age Sex Outcome Treatment
    1 Male