BEUDAMED
    FDA Adverse Event Death Summary report: N

    PRIDE MOBILITY RIO 3 SCOOTER

    MDR report key: 1950724 · Received June 11, 2010

    Report

    Report Number
    MW5018791
    Event Type
    Death
    Date Received
    June 11, 2010
    Date of Event
    June 2, 2010
    Report Date
    June 11, 2010
    Manufacturer
    BRUNO INDEPENDENT LIVING AIDS, INC.
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    MD, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    FAMILY REPORTS THAT THE PT TOOK A SCOOTER OUT FOR A TEST DRIVE AND THE SCOOTER ALLEGEDLY COLLAPSED AND THREW HIM INTO HIS NEIGHBOR'S YARD. PT WAS TAKEN TO (B)(6) HOSPITAL WHERE HE LATER DIED. NO FURTHER INFO IS AVAILABLE AT THIS TIME. SCOOTER DELIVERED TO PT'S HOME ON (B)(6) 2010.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRIDE MOBILITY RIO 3 SCOOTER PRIDE MOBILITY RIO 3 SCOOTER INI BRUNO INDEPENDENT LIVING AIDS, INC. UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 75 YR Death