BEUDAMED
    FDA Adverse Event Injury Summary report: N

    MBT FOOTWEAR

    MDR report key: 2546138 · Received April 18, 2012

    Report

    Report Number
    3009089619-2012-00003
    Event Type
    Injury
    Date Received
    April 18, 2012
    Date of Event
    January 21, 2012
    Manufacturer
    MASAI MARKETING + TRADING AG
    Product Code
    KNP
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Description of Event or Problem · 1

    SHE WAS WALKING DOWN A STEP AND SLIPPED FORWARD. SHE FELL FORWARD AND SIDEWAYS. SHE HAD "EXCRUCIATING PAIN" AND HER FOOT WAS POINTING THE WRONG WAY. SHE MANUALLY PUT HER ANKLE BACK IN PLACE AND SOUGHT MEDICAL HELP.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MBT FOOTWEAR ORTHOSE, CORRECTIVE SHOE KNP MASAI MARKETING + TRADING AG UNK

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Required Intervention| S