BEUDAMED
    FDA Adverse Event Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3121078 · Received May 20, 2013

    Report

    Report Number
    1531186-2013-02137
    Date Received
    May 20, 2013
    Report Date
    April 23, 2013
    Manufacturer
    C.T.M. HOMECARE PRODUCT, INC
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER PROVIDER CONTROLLER FAULT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    221617 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. HOMECARE PRODUCT, INC LYNX

    Patients

    Seq Age Sex Outcome Treatment
    1 Other