FDA Adverse Event
Injury
Summary report: N
PRIDE MOBILITY PRODUCTS
MDR report key: 2873847
·
Received December 14, 2012
Report
- Report Number
- 2530130-2012-00085
- Event Type
- Injury
- Date Received
- December 14, 2012
- Date of Event
- November 19, 2012
- Report Date
- June 20, 2013
- Manufacturer
- PRIDE MOBILITY PRODUCTS
- Product Code
- ITI
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- PA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE DEVICE IS NOT AVAILABLE FOR EVALUATION BY PRIDE AT THIS TIME. SHOULD THE DEVICE OR FURTHER INFORMATION BECOME AVAILABLE, A FOLLOW-UP REPORT WILL THEN BE SUBMITTED.
Additional Manufacturer Narrative · 1
THE DEVICE WAS RETURNED AND EVALUATED. THE ALLEGED INADVERTENT MOVEMENT COULD NOT BE DUPLICATED. THE NATURE OF THE COMPLAINT IS UNKNOWN.
Description of Event or Problem · 1
DEALER CLAIMS CONSUMER WAS ON THE SIDEWALK GOING UP A HILL WHEN ALLEGEDLY THE PWC TOOK AN IMMEDIATE RIGHT AND WENT UP A DIRT HILL.
Description of Event or Problem · 1
DEALER CLAIMS CONSUMER WAS ON THE SIDEWALK GOING UP A HILL WHEN ALLEGEDLY THE PWC TOOK AN IMMEDIATE RIGHT AND WENT UP A DIRT HILL.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | PRIDE MOBILITY PRODUCTS | POWERED WHEELCHAIR | ITI | PRIDE MOBILITY PRODUCTS | Q600 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Hospitalization |