BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    RASCAL

    MDR report key: 528644 · Received March 1, 2004

    Report

    Report Number
    2246975-2004-00010
    Event Type
    Malfunction
    Date Received
    March 1, 2004
    Date of Event
    January 28, 2004
    Report Date
    February 4, 2004
    Manufacturer
    ELECTRIC MOBILITY CORP.
    Product Code
    INI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AL, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    DECRIBE EVENT OR PROBLEM: WHEEL HUB CRACKED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 RASCAL VEHICLE, 3-WHEEL MOTORIZED INI ELECTRIC MOBILITY CORP. 240 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR