BEUDAMED
    FDA Adverse Event Death Summary report: N

    GOLDEN LITERIDER

    MDR report key: 2678577 · Received June 20, 2012

    Report

    Report Number
    3008812160-2012-00001
    Event Type
    Death
    Date Received
    June 20, 2012
    Date of Event
    May 11, 2012
    Report Date
    June 18, 2012
    Manufacturer
    GOLDEN TECHNOLOGIES, INC
    Product Code
    INI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    A (B)(6) WAS DRIVING A MOTORIZED SCOOTER ON A SIDEWALK AND THEN DROVE IT ON THE GRASS, WHERE HE HIT AN OBJECT, CAUSING THE SCOOTER TO TIP OVER AND THEN LAND ON TOP OF HIM. THE CAUSE OF DEATH WAS RULED: "BLUNT FORCE LEG INJURY", WITH THE MANNER OF BEING "ACCIDENTAL".

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 GOLDEN LITERIDER SCOOTER, 3 WHEELED INI GOLDEN TECHNOLOGIES, INC GL110

    Patients

    Seq Age Sex Outcome Treatment
    1 93 YR Death| H