BEUDAMED
    FDA Adverse Event Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3911481 · Received July 3, 2014

    Report

    Report Number
    1531186-2014-02365
    Date Received
    July 3, 2014
    Date of Event
    May 26, 2014
    Report Date
    June 2, 2014
    Manufacturer
    C.T.M. SHANGHAI
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    DEALER ADVISED END USER ADVISED SCOOTER IS FULLY CHARGED GOES FROM ONE ROOM TO ANOTHER A COUPLE OF TIMES AND SCOOTER STOPS, NO INJURY, DEALER COULD NOT PROVIDE ANY FURTHER INFORMATION.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    390238 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. SHANGHAI L-4B

    Patients

    Seq Age Sex Outcome Treatment
    1 Other