BEUDAMED
    FDA Adverse Event Other Summary report: N

    GOLDEN COMPASS

    MDR report key: 3536406 · Received December 24, 2013

    Report

    Report Number
    2523955-2013-00004
    Event Type
    Other
    Date Received
    December 24, 2013
    Date of Event
    October 31, 2013
    Report Date
    December 19, 2013
    Manufacturer
    GOLDEN TECHNOLOGIES, INC.
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    OTHER HEALTH CARE PROFESSIONAL

    Narratives

    Additional Manufacturer Narrative · 1

    UNIT EVALUATED AND THE SOURCE OF THE FIRE WAS UNABLE TO BE DETERMINED. THE SOURCE OF THE FIRE MAY HAVE BEEN FROM AN OUTSIDE SOURCE.

    Description of Event or Problem · 1

    USER'S SON SAID THAT HE PARKED THE WHEELCHAIR IN THE FRONT YARD ON THE GRASS. LATER A NEIGHBOR ADVISED HIM THAT THE WHEELCHAIR WAS ON FIRE. THE (B)(4) FIRE DEPARTMENT WAS SUMMONS TO PUT OUT THE FIRE. THERE WAS NO INJURIES OR WITNESSES TO HOW THE FIRE STARTED NEAR THE REAR OF THE UNIT. THE FIRE REMAINS AS UNKNOWN ORIGIN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    674209 GOLDEN COMPASS ELECTRIC WHEELCHAIR INI GOLDEN TECHNOLOGIES, INC. OP600M

    Patients

    Seq Age Sex Outcome Treatment
    1