BEUDAMED
    FDA Adverse Event Other Summary report: N

    GUARDIAN CANE

    MDR report key: 312809 · Received January 19, 2001

    Report

    Report Number
    2020334-2001-00002
    Event Type
    Other
    Date Received
    January 19, 2001
    Date of Event
    December 14, 2000
    Report Date
    January 19, 2001
    Manufacturer
    SUNRISE MEDICAL / PCP DIVISION
    Product Code
    IPS
    Removal / Correction Number
    NA
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    VA, US
    Reporter Occupation
    PATIENT

    Narratives

    Description of Event or Problem · 1

    IT WAS REPORTED THAT THE END USER HAD JUST GOT UP FROM THE COUCH, HAD TAKEN A FEW STEPS WHEN THE CANE BROKE. THE USER FELL HITTING USER'S HEAD ON A DOOR. REQUIRED STITCHES TO USER'S HEAD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    2664 GUARDIAN CANE CANE IPS SUNRISE MEDICAL / PCP DIVISION 30340 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 72 YR Other