BEUDAMED
    FDA Adverse Event Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3950027 · Received July 22, 2014

    Report

    Report Number
    1531186-2014-02667
    Date Received
    July 22, 2014
    Report Date
    June 13, 2014
    Manufacturer
    C.T.M. TAIWAN
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT WHEN BACK OF THE LEO-4B SCOOTER FOLDED DOWN THE BOLTS SNAPPED OFF.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    429139 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. TAIWAN LEO-4B

    Patients

    Seq Age Sex Outcome Treatment
    1 Other