BEUDAMED
    FDA Adverse Event Death Summary report: N

    CANE, QUAD LARGE BASE ALUMIN

    MDR report key: 438576 · Received January 14, 2003

    Report

    Report Number
    1417592-2003-00002
    Event Type
    Death
    Date Received
    January 14, 2003
    Date of Event
    November 1, 2002
    Report Date
    January 14, 2003
    Manufacturer
    MEDLINE INDUSTRIES, INC.
    Product Code
    IPS
    Adverse Event
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MS, US
    Reporter Occupation
    INVALID DATA

    Narratives

    Description of Event or Problem · 1

    REPORTEDLY A DIALYSIS PT'S FOOT SLIPPED UNDER THE BASE OF THE CANE. THE PT FELL SPRAINING THEIR ANKLE AND FRACTURING THEIR RIGHT PATELLA. PT WAS HOSPITALIZED AND THEN PLACED INTO A SKILLED CARE FACILITY FOR REHABILITATION. THE PT EXPIRED IN 2002 DUE TO COMPLICATIONS FROM HEALTH CONDITIONS THAT WERE NOT RELATED TO THE INCIDENT.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CANE, QUAD LARGE BASE ALUMIN * IPS MEDLINE INDUSTRIES, INC. MDS86228 *

    Patients

    Seq Age Sex Outcome Treatment
    1 89 YR Death