BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RASCAL

    MDR report key: 508981 · Received February 2, 2004

    Report

    Report Number
    2246975-2004-00003
    Event Type
    Injury
    Date Received
    February 2, 2004
    Date of Event
    September 24, 2002
    Report Date
    January 6, 2004
    Manufacturer
    ELECTRIC MOBILITY CORP.
    Product Code
    INI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NV, US
    Reporter Occupation
    ATTORNEY

    Narratives

    Description of Event or Problem · 1

    CUSTOMER DROVE OVER 8" CURB AND LANDED ON SHOULDER. BADLY BRUISES AND CONTINUES TO FILL WITH FLUID REQUIRING A DRAINING PROCEDURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RASCAL VEHICLE, 3-WHEEL MOTORIZED INI ELECTRIC MOBILITY CORP. 245 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 85 YR Other