BEUDAMED
    FDA Adverse Event Injury Summary report: N

    DRIVE MEDICAL

    MDR report key: 3940729 · Received July 2, 2014

    Report

    Report Number
    2438477-2014-00006
    Event Type
    Injury
    Date Received
    July 2, 2014
    Report Date
    June 6, 2014
    Manufacturer
    WU'S TECH CO. LTD.
    Product Code
    INI
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    OH, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    DRIVE MEDICAL HAS RECEIVED A PATIENT COMPLAINT ABOUT AN INCIDENT INVOLVING A 3 WHEEL SCOOTER IMPORTED AND DISTRIBUTED BY DRIVE MEDICAL. THE CLAIMANT ALLEGED THAT SCOOTER'S HAND CONTROL WENT TOO FAST CAUSING HER TO FALL AND ALLEGEDLY BREAK 10 RIBS. DETAILS OF THE INCIDENT AND PRODUCT PROBLEM IS UNKNOWN. THIS MDR REPORT IS BASED ON THE INFORMATION PROVIDED BY THE DME DEALER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    385315 DRIVE MEDICAL VEHICLE, MOTORIZED 3-WHEELED INI WU'S TECH CO. LTD. PHOENIXHD3 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 Required Intervention