BEUDAMED
    FDA Adverse Event Injury Summary report: N

    COMPANION 221

    MDR report key: 380937 · Received February 25, 2002

    Report

    Report Number
    2523955-2002-00001
    Event Type
    Injury
    Date Received
    February 25, 2002
    Date of Event
    December 12, 2001
    Report Date
    February 19, 2002
    Manufacturer
    GOLDEN TECHNOLOGIES, INC.
    Product Code
    INI
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    LEGAL COUNSEL FOR END USER HAS ADVISED THAT END USER WAS INJURED WHEN GOLDEN COMPANION SCOOTER, MODEL GC-221, MALFUNCTIONED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 COMPANION 221 BATTERY POWERED SCOOTER INI GOLDEN TECHNOLOGIES, INC. GC-221 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 NO INFO Other