BEUDAMED
    FDA Adverse Event Injury Summary report: N

    RASCAL

    MDR report key: 513499 · Received March 1, 2004

    Report

    Report Number
    2246975-2004-00011
    Event Type
    Injury
    Date Received
    March 1, 2004
    Date of Event
    December 19, 2003
    Report Date
    February 4, 2004
    Manufacturer
    ELECTRIC MOBILITY CORP.
    Product Code
    INI
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    CUSTOMER WAS STRUCK BY AN AUTOMOBILE WHEN CROSSING AN INTERSECTION.

    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 * Hospitalization