FDA Adverse Event Summary report: N

MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

MDR report key: 3963063 · Received July 29, 2014

Report

Report Number
1531186-2014-02853
Date Received
July 29, 2014
Date of Event
June 20, 2014
Report Date
June 20, 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

DEALER ALLEGED THAT MOTOR HAS SEIZED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
442218 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. TAIWAN PEGASUS4B-8

Patients

Seq Age Sex Outcome Treatment
1 Other