MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a * report with the FDA on 2014-01-17 for CANE, CRUTCH AND WALKER TIPS AND PADS 3920-2 manufactured by Hl Corp. (shenzhen).
[4139499]
It was reported that the weld broke at the leg on the cane.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1531186-2014-00253 |
| MDR Report Key | 3582677 |
| Report Source | * |
| Date Received | 2014-01-17 |
| Date of Report | 2014-01-10 |
| Date of Event | 2014-01-09 |
| Date Facility Aware | 2014-01-10 |
| Report Date | 2014-01-17 |
| Date Reported to FDA | 2014-01-17 |
| Date Reported to Mfgr | 2014-01-17 |
| Date Added to Maude | 2014-01-17 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | PATIENT |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 0 |
| Single Use | 0 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | CANE, CRUTCH AND WALKER TIPS AND PADS |
| Generic Name | 890.3790 |
| Product Code | INP |
| Date Received | 2014-01-17 |
| Model Number | 3920-2 |
| Operator | LAY USER/PATIENT |
| Device Availability | N |
| Device Age | 38 MO |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | HL CORP. (SHENZHEN) |
| Manufacturer Address | THE 3RD INDUSTRIAL PARK BITOU VILLAGE, SONG GANG TOWN BOAN DISTRICT, SHENZHEN 518105 CH 518105 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Other | 2014-01-17 |