BEUDAMED
    FDA Adverse Event Injury Summary report: N

    HUGO

    MDR report key: 525090 · Received May 14, 2004

    Report

    Report Number
    2433043-2004-00001
    Event Type
    Injury
    Date Received
    May 14, 2004
    Date of Event
    April 7, 2004
    Report Date
    May 14, 2004
    Manufacturer
    CAN-AM CARE
    Product Code
    ITJ
    Adverse Event
    Yes
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IN, US
    Reporter Occupation
    NOT APPLICABLE

    Narratives

    Description of Event or Problem · 1

    THE LEFT, REAR LEG OF THE WALKER BROKE CAUSING THE PT TO FALL. THE PT REQUIRED STITCHES FOR A LACERATION TO THEIR FACE/FOREHEAD.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 HUGO ROLLING WALKER ITJ CAN-AM CARE V2.5 NA

    Patients

    Seq Age Sex Outcome Treatment
    1 84 YR Required Intervention