BEUDAMED
    FDA Adverse Event Summary report: N

    CRUTCH

    MDR report key: 2821860 · Received November 6, 2012

    Report

    Report Number
    1531186-2012-01357
    Date Received
    November 6, 2012
    Report Date
    November 6, 2012
    Manufacturer
    JAN MAO
    Product Code
    IPR
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SC, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    (B)(4). NO SERIOUS INJURY ALLEGED. MALFUNCTION ALLEGED. DEALER STATES CRUTCH SNAPPED WHERE IT WOULD ADJUST IN HEIGHT. MDR FILED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CRUTCH 890.3150 IPR JAN MAO 8153-A

    Patients

    Seq Age Sex Outcome Treatment
    1 Other