BEUDAMED
    FDA Adverse Event Summary report: N

    CANES

    MDR report key: 3020339 · Received March 25, 2013

    Report

    Report Number
    1531186-2013-01283
    Date Received
    March 25, 2013
    Date of Event
    February 28, 2013
    Report Date
    February 28, 2013
    Manufacturer
    HL CORP. (SHENZHEN)
    Product Code
    IPS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    OR, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    (B)(4) IT WAS REPORTED BY THE CONSUMER THAT THE 7827 E-Z QUAD CANE BROKE INTO TWO PIECES BY THE WIDE QUAD BASE WHILE IN USE, RESULTING IN THE PATIENT FALLING, AND ALLEGEDLY SUSTAINING UNSPECIFIED BODY PARTS BRUISES. NO MEDICAL ATTENTION WAS SOUGHT, AND NO ADDITIONAL INFORMATION WAS PROVIDED, AND IF WE RECEIVE IT, THIS FILE WILL BE REVISED, AND A SUPPLEMENTAL REPORT WILL BE SUBMITTED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    121772 CANES 890.3075 IPS HL CORP. (SHENZHEN) 7827

    Patients

    Seq Age Sex Outcome Treatment
    1 65 Other