BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RASCAL

    MDR report key: 370413 · Received January 9, 2002

    Report

    Report Number
    2246975-2001-00067
    Event Type
    Injury
    Date Received
    January 9, 2002
    Date of Event
    December 15, 2001
    Report Date
    December 17, 2001
    Manufacturer
    ELECTRIC MOBILITY CORP.
    Product Code
    INI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    CUSTOMER WAS TRAVELING ON A BIKE PATH AND WAS STRUCK BY A MOTOR VEHICLE. CUSTOMER SUSTAINED BROKEN RIBS AND THE UNIT IS DAMAGED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RASCAL VEHICLE, 3-WHEEL, MOTORIZED INI ELECTRIC MOBILITY CORP. 245 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 65 YR Required Intervention