BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    RASCAL

    MDR report key: 2102304 · Received May 16, 2011

    Report

    Report Number
    2246975-2011-00002
    Event Type
    Malfunction
    Date Received
    May 16, 2011
    Date of Event
    August 9, 2010
    Report Date
    May 16, 2011
    Manufacturer
    ELECTRIC MOBILITY CORP.
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Additional Manufacturer Narrative · 1

    ELECTRIC MOBILITY CORP FAILED TO REPORT THIS MALFUNCTION WITHIN 30 DAYS.

    Description of Event or Problem · 1

    SEAT COLLAPSED AND CUSTOMER FELL TO THE FLOOR. SERVICE CENTER REPLACED SEAT LIFT. NO INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RASCAL VEHICLE, 3 WHEELED, MOTORIZED INI ELECTRIC MOBILITY CORP. 600T

    Patients

    Seq Age Sex Outcome Treatment
    1