FDA Adverse Event Injury Summary report: N

ROLL-A-BOUT SCOOTER

MDR report key: 17535955 · Received August 12, 2023

Report

Report Number
MW5142847
Event Type
Injury
Date Received
August 12, 2023
Report Date
March 15, 2022
Manufacturer
UNKNOWN
Product Code
ITJ
Report Source
Voluntary report
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 0

THE END-USER WAS USING THE ROLL-A-BOUT SCOOTER SUPPLIED TO HIM BY PERKINS MEDICAL SUPPLY AND ROSE MEDICAL, TO GO TO HIS VEHICLE WHEN SUDDENLY AND WITHOUT WARNING THE ROLL-A-ABOUT SCOOTER STOPPED AND AS A RESULT, FLUNG HIM FORWARD CAUSING HIM TO LAND FACE FIRST ONTO HIS CEMENT DRIVEWAY. HE DESCRIBED CONTACT OF HIS FACE TO THE CEMENT DRIVEWAY AS SOUNDING LIKE RICE KRISPIES. ON THIS DATE HE HAD A NURSE AT HIS HOME FOR THE INJURY HE SUSTAINED WHILE WORKING CONSTRUCTION. THUS, AFTER THE FAILURE OF PERKINS MEDICAL SUPPLY AND/OR ROSCOE MEDICAL TO PROVIDE INSTRUCTIONS AND WARNINGS REGARDING USE OF THE ROLL-A-BOUT SCOOTER CAUSED HIM TO HIT HIS HEAD, THE HOME NURSE CLEANED UP THE WOUND ON HIS FACE. ON (B)(6) 2018, HIS WIFE TELLS HIS FOOT DOCTOR THAT HE HAS BEEN HAVING MEMORY ISSUES. ON (B)(6) 2018, WORKER'S COMPENSATION FINALLY SENDS HIM TO A DOCTOR TO REFER HIM TO A NEUROLOGIST FOR HIS MEMORY LOSS. ON (B)(6) 2019, WORKER'S COMPENSATION FINALLY GETS HIM IN TO SEE A PSYCHOLOGIST AND HE DIAGNOSES HIM WITH A MILD NEUROCOGNITIVE DISORDER SECONDARY TO A TRAUMATIC BRAIN INJURY. ON (B)(6) 2019, HE REPORTS HIS "MEMORY IS WRONG" AND THAT HE DOES NOT "LOOK FORWARD TO DOING THINGS OR EVEN SEEING MY FAMILY BECAUSE I CAN'T CARRY ON A CONVERSATION". THE DOCTOR NOTES THAT "DUE TO COGNITIVE ISSUES, PATIENT IS NOT ABLE TO WORK." HE IS NOW SEEING A DIFFERENT DOCTOR FOR TREATMENT OF HIS NEUROCOGNITIVE ISSUE THAT IS SECONDARY TO HIS TRAUMATIC BRAIN INJURY. PER MEDICAL REPORT, CUSTOMER HAS 1 TO 3 BEERS A DAY. WE DID NOT INFORM THE MANUFACTURER OF THIS EVENT AS IT IS UNKNOWN IF IT IS OUR PRODUCT OR NOT, WE ARE INSTEAD NOTIFYING YOU. THANK YOU. THIS REPORT REFLECTS INFORMATION RECEIVED BY FDA IN THE FORM OF A NOTIFICATION PER 803.22 (B)(2).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1085962 ROLL-A-BOUT SCOOTER WALKER, MECHANICAL ITJ UNKNOWN

Patients

Seq Age Sex Outcome Treatment
1 Unknown