BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    SCOOTER

    MDR report key: 195687 · Received October 30, 1998

    Report

    Report Number
    2530130-1998-00003
    Event Type
    Malfunction
    Date Received
    October 30, 1998
    Date of Event
    November 21, 1995
    Report Date
    October 12, 1998
    Manufacturer
    PRIDE HEALTH CARE INC
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    WHEN KEY WAS INSERTED IN THE CONTROL PANEL, SCOOTER WENT INTO REVERSE AT HIGH SPEED, HIT CAR AND FINALLY STOPPED. NO INJURIES WERE SUSTAINED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 SCOOTER SCOOTER INI PRIDE HEALTH CARE INC UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNKNOWN