BEUDAMED
    FDA Adverse Event Injury Summary report: N

    CYPRESS

    MDR report key: 2642214 · Received June 26, 2012

    Report

    Report Number
    1451040-2012-00013
    Event Type
    Injury
    Date Received
    June 26, 2012
    Date of Event
    May 23, 2012
    Report Date
    May 28, 2012
    Manufacturer
    GENTRY WAY CO., LTD.
    Product Code
    IPR
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Distributor report
    Reporter Location
    GA, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED TO US THAT AN END USER WAS USING CRUTCHES TO GO UP STAIRS AND THE HAND GRIP BROKE OFF. THE END USER LANDED ON TOP OF THE CRUTCH WHEN HE FELL. HE WENT TO THE HOSPITAL, WHERE HE WAS DIAGNOSED WITH BROKEN/FRACTURED RIBS.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CYPRESS CRUTCH, ALUMINUM IPR GENTRY WAY CO., LTD.

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK Hospitalization