BEUDAMED
    FDA Adverse Event Summary report: N

    CANES

    MDR report key: 3031634 · Received April 2, 2013

    Report

    Report Number
    1531186-2013-01361
    Date Received
    April 2, 2013
    Report Date
    April 1, 2013
    Manufacturer
    PINGHU WEIFENG MATERIAL TECHNOLOGY
    Product Code
    IPS
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MI, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    (B)(4) - COPY OF MEDWATCH 3500A REPORT INDICATING UF/IMPORTER REPORT #(B)(4) WAS RECEIVED BY INVACARE. MDR BEING FILED BASED ON THE INFORMATION RECEIVED.

    Description of Event or Problem · 1

    THE END USER STATED THE CANE COLLAPSED ON HER WHEN SHE WAS WALKING ON HER PORCH.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    135115 CANES 890.3075 IPS PINGHU WEIFENG MATERIAL TECHNOLOGY 40918

    Patients

    Seq Age Sex Outcome Treatment
    1 62 Other