FDA Adverse Event Summary report: N

MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

MDR report key: 2946387 · Received February 6, 2013

Report

Report Number
1531186-2013-00431
Date Received
February 6, 2013
Report Date
February 6, 2013
Manufacturer
C.T.M. HOMECARE PRODUCT, INC
Product Code
INI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES THAT THE SWITCH IS CRACKED AND CAME APART. NEW BRAKE HARDWARE WAS SENT FOR REPAIR. NO INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
49726 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. HOMECARE PRODUCT, INC L-4B

Patients

Seq Age Sex Outcome Treatment
1 Other