BEUDAMED
    FDA Adverse Event Injury Summary report: N

    PRIDE MOBILITY PRODUCTS

    MDR report key: 2211952 · Received August 15, 2011

    Report

    Report Number
    2530130-2011-00034
    Event Type
    Injury
    Date Received
    August 15, 2011
    Date of Event
    May 12, 2011
    Report Date
    August 11, 2011
    Manufacturer
    PRIDE MOBILITY PRODUCTS
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Additional Manufacturer Narrative · 1

    DEVICE NOT AVAILABLE FOR EVALUATION. WILL SUBMIT A FOLLOW-UP INVESTIGATION REPORT SHOULD THE DEVICE BECOME AVAILABLE.

    Description of Event or Problem · 1

    THE END USER ALLEGES THAT HIS LOWER EXTREMITIES DO NOT PROPERLY FIT INTO FRONT RIGGINGS OF UNIT. REQUESTING STRAPS FROM DEALER. LEFT FOOT FELL OFF RIGGINGS AND SUSTAINED FOOT INJURY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRIDE MOBILITY PRODUCTS POWERED WHEELCHAIR ITI PRIDE MOBILITY PRODUCTS QUANTUM 600

    Patients

    Seq Age Sex Outcome Treatment
    1 Hospitalization