BEUDAMED
    FDA Adverse Event Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 3955201 · Received July 24, 2014

    Report

    Report Number
    1531186-2014-02697
    Date Received
    July 24, 2014
    Date of Event
    June 16, 2014
    Report Date
    June 17, 2014
    Manufacturer
    C.T.M. SHANGHAI
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NJ, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THAT THE USER GOES TO THE PARK DAILY AND NOTICES THAT THE SCOOTER TENDS TO STOP ON HER RIDE TO AND FROM. CONSUMER ADVISED THAT THE USERS HUSBAND HAS THE SAME SCOOTER AND HIS DOES NOT STOP DURING THE TRIP. PROVIDER DID A LOAD TEST ON THE BATTERIES AND THEY FAILED. NO ADDITIONAL INFORMATION PROVIDED

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    434500 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. SHANGHAI L-3R

    Patients

    Seq Age Sex Outcome Treatment
    1 Other