FDA Adverse Event Malfunction Summary report: N

BREG POST-OP SHOE

MDR report key: 3784764 · Received May 1, 2014

Report

Report Number
2028253-2014-00010
Event Type
Malfunction
Date Received
May 1, 2014
Date of Event
April 14, 2014
Report Date
May 1, 2014
Manufacturer
BREG, INC.
Product Code
IQI
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE EVALUATION HAS CONFIRMED SEPARATION OF THE SOLE FROM THE SHOE. THE SUPPLIER OF THE POST-OP SHOE HAS BEEN ISSUED A CORRECTIVE ACTION AND HAS BEEN UNABLE TO DETERMINE THE ROOT CAUSE OF THE FAILURE. BREG IS NO LONGER DISTRIBUTING THIS PRODUCT.

Description of Event or Problem · 1

FRONT OF THE SHOE COMING APART ON A POST-OP SHOE AFTER 1.5 WEEKS OF USE. NO INJURY WAS REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
261320 BREG POST-OP SHOE POST-OP SHOE IQI BREG, INC. 11193

Patients

Seq Age Sex Outcome Treatment
1