FDA Adverse Event
Summary report: N
MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT
MDR report key: 2884440
·
Received December 22, 2012
Report
- Report Number
- 1531186-2012-01848
- Date Received
- December 22, 2012
- Report Date
- December 21, 2012
- Manufacturer
- C.T.M. HOMECARE PRODUCT, INC
- Product Code
- INI
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
(B)(4) - IT WAS REPORTED BY THE CONSUMER THAT THE PEGASUS4-S SCOOTER WAS HAVING ISSUES WITH THE PC BOARD. THERE WAS NO PATIENT INJURY REPORTED.
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 | PEGASUS4-S |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |