BEUDAMED
    FDA Adverse Event Summary report: N

    PRIDE

    MDR report key: 1993415 · Received February 16, 2011

    Report

    Report Number
    2530130-2011-00007
    Date Received
    February 16, 2011
    Date of Event
    December 15, 2010
    Report Date
    February 15, 2011
    Manufacturer
    PRIDE MOBILITY PRODUCTS CORPORATION
    Product Code
    INI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    PRIDE COMPANY REPRESENTATIVES, THE FIRE MARSHAL, CAUSE AND ORIGIN EXPERTS, AND AN ELECTRICAL ENGINEER PERFORMED PRODUCT INVESTIGATIONS ON TWO OCCASIONS. THE INITIAL WAS PERFORMED AT THE FIRE SCENE, AND THE SECOND WAS PERFORMED AT THE FIRE MARSHAL'S OFFICE. THE CONDITION OF THE SCOOTER CONSISTED MOSTLY OF METAL, AND THE PRODUCT MODEL AND SERIAL NUMBER COULD NOT BE IDENTIFIED. THE LEFT REAR TIRE WAS RECOGNIZABLE, AND AS A RESULT THE PRODUCT WAS GIVEN A TENTATIVE IDENTIFICATION AS A 1999 CELEBRITY. A SERIAL NUMBER IS NEEDED TO POSITIVELY IDENTIFY THE SCOOTER AS A PRODUCT MANUFACTURED BY PRIDE MOBILITY PRODUCTS CORPORATION. THE RESULTS OF THE SCOOTER INSPECTIONS DETERMINED THAT THERE WAS NOTHING TO INDICATE THE SCOOTER WAS A CAUSE OF THE EVENT. THE EXPERTS CONCLUSION WAS THAT THE CAUSE OF THE FAILURE AND RESULTING FIRE COULD NOT BE DETERMINED.

    Description of Event or Problem · 1

    AN ALLEGED FIRE OCCURRED AT AN APARTMENT COMPLEX. A SCOOTER PRODUCT WAS NEAR A CLOSET AREA WHERE THE FIRE MAY HAVE STARTED. THE USER REQUIRED HOSPITALIZATION; NO INFORMATION WAS AVAILABLE ON THE USER'S CONDITION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRIDE SCOOTER INI PRIDE MOBILITY PRODUCTS CORPORATION CELEBRITY

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization