BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3200296 · Received July 1, 2013

    Report

    Report Number
    1525712-2013-05195
    Event Type
    Malfunction
    Date Received
    July 1, 2013
    Report Date
    June 5, 2013
    Manufacturer
    INVACARE TAYLOR STREET
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    END USER STATES A TIRE ON HIS 220 SCOOTER BLEW OUT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    300095 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI INVACARE TAYLOR STREET 220

    Patients

    Seq Age Sex Outcome Treatment
    1 Other