BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CANE

    MDR report key: 6213097 · Received June 14, 2013

    Report

    Report Number
    1000282279-2013-00042
    Event Type
    Malfunction
    Date Received
    June 14, 2013
    Report Date
    June 13, 2013
    Manufacturer
    FOSHAN R. POON MEDICAL PRODUCTS CO., LTD.
    Product Code
    KHY
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    GA, US
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    PER IMPORTER'S MDR: CLIENT'S DAUGHTER ALLEGES HER MOTHER WAS JUST WALKING AND THE QUAD CANE BROKE IN HALF CAUSING HER MOTHER TO FALL AND GET MULTIPLE BRUISES.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    272376 CANE CANE KHY FOSHAN R. POON MEDICAL PRODUCTS CO., LTD.

    Patients

    Seq Age Sex Outcome Treatment
    1 79 YR Other