FDA Adverse Event Summary report: N

MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

MDR report key: 2648375 · Received July 10, 2012

Report

Report Number
1531186-2012-00513
Date Received
July 10, 2012
Report Date
October 9, 2012
Manufacturer
C.T.M. HOMECARE PRODUCT, INC
Product Code
INI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Additional Manufacturer Narrative · 1

(B)(4). FOLLOW-UP #001. INITIAL PR #(B)(4) ISSUED MFR. REPORT #1531186-2012-00513 INDICATING THE MANUFACTURER AS CT MEDICAL, INC. THE CORRECT MANUFACTURER IS C.T.M. HOMECARE PRODUCTS.

Description of Event or Problem · 1

CUSTOMER ALLEGED THAT SCOOTER MADE A WHINING NOISE & STOPPED INTERMITTENTLY. (B)(4). NO INJURY ALLEGED.

Description of Event or Problem · 1

CUSTOMER ALLEGED THAT SCOOTER MADE A WHINING NOISE AND STOPPED INTERMITTENTLY. QUOTE #(B)(4). NO INJURY ALLEGED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. HOMECARE PRODUCT, INC L4R

Patients

Seq Age Sex Outcome Treatment
1 Other