BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RASCAL

    MDR report key: 508968 · Received February 2, 2004

    Report

    Report Number
    2246975-2004-00002
    Event Type
    Injury
    Date Received
    February 2, 2004
    Date of Event
    November 28, 2003
    Report Date
    January 5, 2004
    Manufacturer
    ELECTRIC MOBILITY CORP.
    Product Code
    INI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OH, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    CUSTOMER HIT A POT HOLE IN ROAD AND UPSET UNIT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RASCAL VEHICLE, 3-WHEEL MOTORIZED INI ELECTRIC MOBILITY CORP. 600T NA

    Patients

    Seq Age Sex Outcome Treatment
    1 52 YR Hospitalization