FDA Adverse Event Malfunction Summary report: N

DRIVE

MDR report key: 17386416 · Received July 24, 2023

Report

Report Number
9616873-2023-00004
Event Type
Malfunction
Date Received
July 24, 2023
Report Date
June 8, 2023
Manufacturer
WU'S TECH CO., LTD.
Product Code
ITI
UDI-DI
00822383579559
Report Source
Manufacturer 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
1271413 DRIVE POWERED WHEELCHAIR ITI WU'S TECH CO., LTD. PHOENIXHD4-20 00822383579559

Patients

Seq Age Sex Outcome Treatment
1 Male