BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MAX MOBILITY SMART DRIVE

    MDR report key: 17128638 · Received June 13, 2023

    Report

    Report Number
    MW5118391
    Event Type
    Injury
    Date Received
    June 13, 2023
    Date of Event
    March 15, 2022
    Report Date
    June 10, 2023
    Manufacturer
    MAX MOBILITY, LLC
    Product Code
    ITI
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    NM, US
    Reporter Occupation
    PATIENT
    Health Professional
    *

    Narratives

    Description of Event or Problem · 0

    I WAS USING A TIC WATCH E3 WITH THE SMART DRIVE MX2+ WITHOUT CONNECTING TO MY PHONE OR USING OTHER APPS OTHER THAN THE MX2+ APP I USED THE WATCH TO GO UP MY VAN RAMP AFTER DOUBLE TAPPING TWICE TO ACTIVATE THE SMART DRIVE TURNED ON, BUT WHEN I TAPPED ONCE MORE TO STAY AT CERTAIN SPEED THE SMART DRIVE DID NOT DETECT THE TAP AND KEPT SPEEDING UP MAKING IT ACCELERATE AND CRASHED INTO THE MY VAN. I CONTACTED MAX MOBILITY AND THEY REFUSED TO HELP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    945303 MAX MOBILITY SMART DRIVE WHEELCHAIR, POWERED ITI MAX MOBILITY, LLC

    Patients

    Seq Age Sex Outcome Treatment
    1 30 YR Male Disability| O