BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3699601 · Received March 25, 2014

    Report

    Report Number
    1525712-2014-01370
    Event Type
    Malfunction
    Date Received
    March 25, 2014
    Date of Event
    February 14, 2014
    Report Date
    February 24, 2014
    Manufacturer
    UNKNOWN
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    FL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Additional Manufacturer Narrative · 1

    .

    Description of Event or Problem · 1

    END USER STATED THAT THE SCOOTER NO LONGER GOES FORWARD BUT ONLY GOES INTO REVERSE. DEALER STATED NO INJURIES NOR ISSUES OF ABANDONMENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    174632 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI UNKNOWN L-4B

    Patients

    Seq Age Sex Outcome Treatment
    1 Other