FDA Adverse Event Summary report: N

MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT

MDR report key: 4222476 · Received November 4, 2014

Report

Report Number
1531186-2014-05322
Date Received
November 4, 2014
Date of Event
October 14, 2014
Report Date
October 14, 2014
Manufacturer
C.T.M. SHANGHAI
Product Code
INI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

Narratives

Description of Event or Problem · 1

THE DEALER STATES THE MOTOR DRAGGING INTERMITTENT 5 FLASHING LIGHTS AND BATTERY GAGE WILL DROP SUDDENLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
706150 MOTORIZED 3-WHEELED VEHICLE FOR OUTSIDE TRANSPORT 890.3800 INI C.T.M. SHANGHAI L-3R

Patients

Seq Age Sex Outcome Treatment
1 Other