BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    HEAVY DUTY FOREARM CRUTCHES

    MDR report key: 146779 · Received February 2, 1998

    Report

    Report Number
    MW1012905
    Event Type
    Malfunction
    Date Received
    February 2, 1998
    Date of Event
    January 26, 1998
    Report Date
    February 2, 1998
    Manufacturer
    HARVY SURGICAL SUPPLY CORP.
    Product Code
    IPR
    Product Problem
    Yes
    Report Source
    Voluntary report
    Reporter Location
    TX, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    ON 1/26/98 A RIGHT HIP DISARTICULATED VETERAN WAS ISSUED CRUTCHES, BY A FACILITY. PT REC'D A TELEPHONE MESSAGE FROM THE FACILITY'S DEPT OF PROSTHETIC SVCS SAYING THEY ISSUED HIM THE WRONG PAIR OF FOREARM CRUTCHES. THE CRUTCHES WERE SUPPOSED TO BE FOR ANOTHER DISABLED VETERAN AND FACILITY REQUESTED FOR CRUTCHES TO BE RETURNED. IN THE MEAN TIME PT HAD ALREADY USED CRUTCHES. WHILE PT WAS WALKING IN HIS KITCHEN, THE NUT BROKE OFF. BROKEN FOREARM CUFF AND A METAL SCREW WILL BE RETAINED BY PT. PT WILL RETURN THE CRUTCHES TO THE FACILITY'S PROSTHETIC SVCS DEPT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HEAVY DUTY FOREARM CRUTCHES CRUTCHES IPR HARVY SURGICAL SUPPLY CORP. UNK UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 44 YR Other