BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PRIDE MOBILITY PRODUCTS

    MDR report key: 19228987 · Received May 2, 2024

    Report

    Report Number
    2530130-2024-00415
    Event Type
    Injury
    Date Received
    May 2, 2024
    Date of Event
    April 5, 2022
    Report Date
    May 2, 2024
    Manufacturer
    PRIDE MOBILITY PRODUCTS
    Product Code
    INI
    UDI-DI
    00606509300339
    PMA / PMN Number
    K072165
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    003

    Narratives

    Additional Manufacturer Narrative · 0

    THE DEVICE HAS NOT YET BEEN MADE AVAILABLE FOR EVALUATION. SHOULD FURTHER INFORMATION OR THE DEVICE BECOME AVAILABLE, A FOLLOW-UP REPORT WILL THEN BE ISSUED.

    Description of Event or Problem · 0

    CONSUMER RENTED SCOOTER AT MT. CASINO RESORT IN NV. THE #13 RENTAL SCOOTER WAS BEING USED BY MS. (B)(6) TO ENTER AN ELEVATOR. THE SCOOTER DID NOT ACCELERATE AS SHE ENTERED THE ELEVATOR. WAS STOPPED ON THRESHOLD AND DOOR STARTED TO CLOSE. ALL OF A SUDDEN THE UNIT ALLEGEDLY TOOK OFF AND SHE RAN INTO THE ELEVATOR WALL.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    858307 PRIDE MOBILITY PRODUCTS VEHICLE, MOTORIZED 3-WHEELED INI PRIDE MOBILITY PRODUCTS VICTORY 10 3 WHEEL N/A 00606509300339

    Patients

    Seq Age Sex Outcome Treatment
    1 NA Female Other