BEUDAMED
    FDA Adverse Event Injury Summary report: N

    OTTO BOCK TUBE ADAPTER (TITANIUM 30MM ALUMINUM ALOE TUBE)

    MDR report key: 30749 · Received February 1, 1996

    Report

    Report Number
    30749
    Event Type
    Injury
    Date Received
    February 1, 1996
    Date of Event
    July 17, 1995
    Report Date
    July 24, 1995
    Manufacturer
    OTTO BOCK, ORTHOPEDIC INDUSTRY, INC.
    Product Code
    ISH
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    User Facility report
    Reporter Location
    ME, US
    Reporter Occupation
    RISK MANAGER

    Narratives

    Description of Event or Problem · 1

    PT WALKING ON LEG PROSTHESIS. THE TUBE ADAPTER COMPONENT OF PROSTHESIS BROKE. PT FELL FRACTURING HIP. SURGICAL REDUCTION AND INTERNAL FIXATION PERFORMED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 OTTO BOCK TUBE ADAPTER (TITANIUM 30MM ALUMINUM ALOE TUBE) TUBE ADAPTER (TITANIUM 30MM ALUMINUM ALOE TUBE) ISH OTTO BOCK, ORTHOPEDIC INDUSTRY, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1 69 YR Hospitalization| R