FDA Adverse Event
Death
Summary report: N
PRIDE "SHUTTLE"
MDR report key: 200146
·
Received December 2, 1998
Report
- Report Number
- 2530130-1998-00042
- Event Type
- Death
- Date Received
- December 2, 1998
- Date of Event
- August 26, 1997
- Report Date
- November 30, 1998
- Manufacturer
- PRIDE HEALTH CARE, INC.
- Product Code
- INI
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- OTHER
Narratives
Description of Event or Problem · 1
USER WAS ATTEMPTING TO CLIMB A STEEP HILL AND WAS UNABLE TO GET MORE THAN HALF WAY UP THE HILL APPARENTLY DUE TO A LOW BATTERY. USER APPARENTLY TOOK IT OUT OF GEAR INTO NEUTRAL AND ATTEMPTED TO BACK DOWN THE HILL WHEN IT SWERVED AND STRUCK A CURB BACKWARDS. THE SCOOTER TIPPED OVER AND THE USER FELL ON CURB AND SIDEWALK. USER PASSED AWAY ON 9/6/97.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PRIDE "SHUTTLE" | THREE WHEEL SCOOTER | INI | PRIDE HEALTH CARE, INC. | SC100 | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | 56 YR | Death |