FDA Adverse Event
Death
Summary report: N
PRIDE MOBILITY PRODUCTS
MDR report key: 3821817
·
Received May 20, 2014
Report
- Report Number
- 2530130-2014-00038
- Event Type
- Death
- Date Received
- May 20, 2014
- Date of Event
- April 30, 2014
- Report Date
- March 9, 2015
- Manufacturer
- PRIDE MOBILITY PRODUCTS
- Product Code
- ITI
- PMA / PMN Number
- K042612
- Removal / Correction Number
- N/A
- Adverse Event
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
AN INSPECTION WAS CONDUCTED AND THERE IS NO EVIDENCE THAT THE PRODUCT WAS THE CAUSE OF THE EVENT.
Additional Manufacturer Narrative · 1
THE DEVICE HAS NOT BEEN MADE AVAILABLE FOR EVALUATION. SHOULD FURTHER INFORMATION OR THE DEVICE BECOME AVAILABLE, A FOLLOW-UP REPORT WILL THEN BE ISSUED.
Description of Event or Problem · 1
RECEIVED PROPERTY DAMAGE NOTICE OF A FIRE THAT OCCURRED WHERE A PRIDE POWERCHAIR WAS LOCATED. TENANT PASSED AWAY DUE TO FIRE.
Description of Event or Problem · 1
RECEIVED PROPERTY DAMAGE NOTICE OF A FIRE THAT OCCURRED WHERE A PRIDE POWERCHAIR WAS LOCATED. TENANT PASSED AWAY DUE TO FIRE.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 299587 | PRIDE MOBILITY PRODUCTS | POWERED WHEELCHAIR | ITI | PRIDE MOBILITY PRODUCTS | Q600 | N/A |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Death |