FDA Adverse Event Malfunction Summary report: N

SURE GRIP ORTHO CANE

MDR report key: 7706266 · Received July 20, 2018

Report

Report Number
1000282279-2018-00001
Event Type
Malfunction
Date Received
July 20, 2018
Date of Event
June 19, 2018
Report Date
July 20, 2018
Manufacturer
FOSHAN NANHAI R. POON MEDICAL PRODUCTS CO., LTD.
Product Code
IPS
UDI-DI
00754756914530
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
OTHER

Narratives

Description of Event or Problem · 1

END USER WAS WALKING WITH A CANE WHEN THE SHAFT SNAPPED. THERE WAS NO FALL OR INJURY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
549987 SURE GRIP ORTHO CANE CANE IPS FOSHAN NANHAI R. POON MEDICAL PRODUCTS CO., LTD. RPM79030-BRZ 00754756914530

Patients

Seq Age Sex Outcome Treatment
1 40 YR