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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: PRIDE MOBILITY PRODUCTS CORPORATION PRIDE MOBILITY PRODUCTS; VEHICLE, MOTORIZED 3-WHEELED

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PRIDE MOBILITY PRODUCTS CORPORATION PRIDE MOBILITY PRODUCTS; VEHICLE, MOTORIZED 3-WHEELED Back to Search Results
Model Number GO GO ELITE TRAVELLER 3 WHEEL
Medical Device Problem Code Appropriate Device Problem Term/Code Not Available (3191)
Health Effect - Clinical Code Abrasion (1689)
Type of Reportable Event Serious Injury
Additional Manufacturer Narrative
The device has not yet been made available for evaluation.Should further information or the device become available, a follow-up report will then be issued.
 
Event or Problem Description
Consumer's husband alleges consumer is allegedly getting pressure sores/ulcers from the seat.
 
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Brand Name
PRIDE MOBILITY PRODUCTS
Common Device Name
VEHICLE, MOTORIZED 3-WHEELED
Manufacturer (Section D)
PRIDE MOBILITY PRODUCTS CORPORATION
401 york avenue
duryea PA 18642
Manufacturer (Section G)
N/A
n/a
n/a
n/a
Manufacturer Contact
kelly livingston
401 york avenue
duryea, PA 18462
8008008586
MDR Report Key22182645
Report Number2530130-2025-00860
Device Sequence Number8617418
Product Code INI
UDI-Device Identifier00606509300094
UDI-Public00606509300094
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
K090524
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Consumer,Distributor
Initial Reporter Occupation Non-Healthcare Professional
Type of Report Initial
Report Date (Section B) 06/10/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Operator of Device Lay User/Patient
Device Model NumberGO GO ELITE TRAVELLER 3 WHEEL
Device Catalogue NumberN/A
Device Lot NumberN/A
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/28/2025
Initial Report FDA Received Date06/11/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/28/2022
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Outcome Attributed to Adverse Event Other;
Patient SexFemale
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