BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    AMIGO (RD W/TILT-N-SPACE SEAT)

    MDR report key: 598955 · Received April 27, 2005

    Report

    Report Number
    1821729-2005-00001
    Event Type
    Malfunction
    Date Received
    April 27, 2005
    Date of Event
    April 21, 2005
    Report Date
    April 27, 2005
    Manufacturer
    AMIGO MOBILITY INTL., INC.
    Product Code
    INI
    Report Source
    Manufacturer report
    Reporter Location
    MD, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CUST0MER ALLEGES TILT-N-SPACE SEAT CAUGHT ON FIRE; AID PUT IT OUT IMMEDIATELY WITH FIRE EXTINGUISHER.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 AMIGO (RD W/TILT-N-SPACE SEAT) MOTORIZED SCOOTER WITH SEAT INI AMIGO MOBILITY INTL., INC. 310000 *

    Patients

    Seq Age Sex Outcome Treatment
    1 42 YR