BEUDAMED
    FDA Adverse Event Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3830337 · Received May 23, 2014

    Report

    Report Number
    1531186-2014-01954
    Date Received
    May 23, 2014
    Report Date
    April 14, 2014
    Manufacturer
    C.T.M. SHANGHAI
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    PA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    POINTS ARE DISENGAGING CAUSING THE SCOOTER TO COME APART.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    307474 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. SHANGHAI L-3R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other