BEUDAMED
    FDA Adverse Event Summary report: N

    MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

    MDR report key: 4211405 · Received October 29, 2014

    Report

    Report Number
    1531186-2014-05165
    Date Received
    October 29, 2014
    Report Date
    October 8, 2014
    Manufacturer
    C.T.M. SHANGHAI
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PROVIDER STATES THAT THE CONSUMER ADVISED WHEN SHE HITS A BUMP WITH HER SCOOTER IT WILL SHUT OFF AND SHE HAS TO TURN IT BACK ON TO GET IT TO MOVE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    692867 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. SHANGHAI L-3B

    Patients

    Seq Age Sex Outcome Treatment
    1 Other