FDA Adverse Event Summary report: N

MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

MDR report key: 3191559 · Received June 26, 2013

Report

Report Number
1531186-2013-02802
Date Received
June 26, 2013
Report Date
May 31, 2013
Manufacturer
C.T.M. HOMECARE PRODUCT, INC
Product Code
INI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

PROVIDER STATES THE UNIT DIES OUT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
290092 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