BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 4018026 · Received August 18, 2014

    Report

    Report Number
    1525712-2014-04785
    Event Type
    Malfunction
    Date Received
    August 18, 2014
    Report Date
    July 16, 2014
    Manufacturer
    UNKNOWN
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CT, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE L-3XB SCOOTER IS MISSING COMPONENTS. ALSO PLASTIC PIECE FOR SEAT BROKE DURING TRANSPORT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    494082 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI UNKNOWN L-3XB

    Patients

    Seq Age Sex Outcome Treatment
    1 Other