BEUDAMED
    FDA Adverse Event Injury Summary report: N

    FOLDING ADJ. CANE DERBY HANDLE 7/8 BRONZE

    MDR report key: 2234119 · Received August 30, 2011

    Report

    Report Number
    1219232-2011-00010
    Event Type
    Injury
    Date Received
    August 30, 2011
    Date of Event
    June 10, 2011
    Report Date
    August 29, 2011
    Manufacturer
    VALENTINE INT LTD (TAIWAN)
    Product Code
    IPS
    Adverse Event
    Yes
    Report Source
    Distributor report
    Reporter Location
    CA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    END USER REPORTED THAT THE HEIGHT ADJUSTMENT BUTTON WAS STUCK AT THE TOP OF THE CANE. WHEN END USER CONTACTED MABIS/DMI REGARDING THE STUCK BUTTON, SHE WAS INSTRUCTED TO PULL THE TOP/BOTTOM SECTION APART. UPON PULLING THE TOP SECTION APART, THE ELASTIC BAND SNAPPED, STRIKING HER IN THE FINGER. AS A RESULT, HER LEFT INDEX FINGER WAS BROKEN.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 FOLDING ADJ. CANE DERBY HANDLE 7/8 BRONZE CANE IPS VALENTINE INT LTD (TAIWAN) 502-1316-5400 UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 57 YR Required Intervention