BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    PRIDE LEGEND

    MDR report key: 33679 · Received June 21, 1996

    Report

    Report Number
    MW1009352
    Event Type
    Malfunction
    Date Received
    June 21, 1996
    Date of Event
    June 8, 1996
    Report Date
    June 15, 1996
    Manufacturer
    PRIDE HEALTH CARE, INC.
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    OH, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    THREE-WHEELED SCOOTER TOOK OFF ON ITS OWN. COULD ONLY BE STOPPED BY REMOVING KEY. AFTER INSERTING KEY, SCOOTER ACTION WAS ERRATIC. SOMETIMES FORWARD, REVERSE, OR NOT AT ALL. SOMETIMES WHEN ACTIVATED, OTHER TIMES WITHOUT BEING ACTIVATED. FINALLY RETURNED TO DEALER AND RETURNED TO FACTORY. A BAD SITUATION FOR A HANDICAPPED PERSON.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 PRIDE LEGEND 3 WHEELED SCOOTER INI PRIDE HEALTH CARE, INC. SC 300

    Patients

    Seq Age Sex Outcome Treatment
    1 60 YR