BEUDAMED
    FDA Adverse Event Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3940935 · Received July 17, 2014

    Report

    Report Number
    1525712-2014-03753
    Date Received
    July 17, 2014
    Report Date
    June 10, 2014
    Manufacturer
    UNKNOWN
    Product Code
    INI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    LA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    CUSTOMER STATES THAT SHE FELL ON THE SCOOTER AND SHE CRACKED THE ARM OF HER SCOOTER AND SHE HAD INJURY TO HER ANKLE AND WAS CASTED. CUSTOMER DISCONNECTED AND THIS INFO CAME FROM CUSTOMER SERVICE. TIED TO CALL CUSTOMER AND NO ANSWER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    420098 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI UNKNOWN UNKNOWN

    Patients

    Seq Age Sex Outcome Treatment
    1 Other