BEUDAMED
    FDA Adverse Event Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3913704 · Received July 3, 2014

    Report

    Report Number
    1531186-2014-02376
    Date Received
    July 3, 2014
    Date of Event
    May 16, 2014
    Report Date
    May 30, 2014
    Manufacturer
    C.T.M. SHANGHAI
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    WA, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT TE FREE WHEEL LEVER ON THE BACK OF THE L-4R SCOOTER IS NOT WORKING. THE SCOOTER CANNOT COME OUT OF DRIVE MODE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    390319 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. SHANGHAI L-4R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other