FDA Adverse Event
Malfunction
Summary report: N
LYNX L-3X COMPACT SCOOTER - BLUE 9153645573
MDR report key: 4332350
·
Received December 16, 2014
Report
- Report Number
- 1531186-2014-06254
- Event Type
- Malfunction
- Date Received
- December 16, 2014
- Report Date
- October 28, 2014
- Manufacturer
- C.T.M. SHANGHAI
- Product Code
- INI
- Product Problem
- Yes
- Report Source
- Distributor report
- Reporter Location
- FL, US
- Reporter Occupation
- MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE
Narratives
Description of Event or Problem · 1
IT HAS BEEN REPORTED BY A DEALER THAT THE BRACKET THAT HOLDS THE SEAT TO THE BACK OF A L-3XB SCOOTER SNAPPED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 825228 | LYNX L-3X COMPACT SCOOTER - BLUE 9153645573 | VEHICLE, MOTORIZED 3-WHEELED | INI | C.T.M. SHANGHAI | L-3XB |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | Other |