BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    RASCAL

    MDR report key: 380887 · Received March 8, 2002

    Report

    Report Number
    2246975-2002-00006
    Event Type
    Malfunction
    Date Received
    March 8, 2002
    Date of Event
    February 13, 2002
    Report Date
    February 15, 2002
    Manufacturer
    ELECTRIC MOBILITY CORP
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    THE CUSTOMER STATED THAT WHILE CROSSING AN INTERSECTION THE UNIT HESITATED MOMENTARILY AND THEN WAS STRUCK BY A MOTOR VEHICLE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RASCAL VEHICLE, 4-WHEEL MOTORIZED ITI ELECTRIC MOBILITY CORP 325 R0200929

    Patients

    Seq Age Sex Outcome Treatment
    1 58 YR Hospitalization