BEUDAMED
    FDA Adverse Event Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3123046 · Received May 21, 2013

    Report

    Report Number
    1531186-2013-02176
    Date Received
    May 21, 2013
    Report Date
    April 26, 2013
    Manufacturer
    C.T.M. HOMECARE PRODUCT, INC
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES ALLEGEDLY EVERY TIME SCOOTER GOES OVER A BUMP THE BATTERY BOX DISCONNECTS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    224731 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. HOMECARE PRODUCT, INC L-3B

    Patients

    Seq Age Sex Outcome Treatment
    1 Other