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 |