BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RASCAL

    MDR report key: 512037 · Received February 18, 2004

    Report

    Report Number
    2246975-2004-00006
    Event Type
    Injury
    Date Received
    February 18, 2004
    Date of Event
    January 20, 2004
    Report Date
    January 21, 2004
    Manufacturer
    ELECTRIC MOBILITY CORP.
    Product Code
    ITI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CO, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    TIPPED BACKWARDS GOING UP A WET RAMP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RASCAL POWERCHAIR ITI ELECTRIC MOBILITY CORP. TURNABOUT NA

    Patients

    Seq Age Sex Outcome Treatment
    1 55 YR Required Intervention