OFFSET HANDLE CANE - BLACK 1616710017 40918-6

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a * report with the FDA on 2015-01-09 for OFFSET HANDLE CANE - BLACK 1616710017 40918-6 manufactured by Unknown.

Event Text Entries

[5120772] The end user alleges, the cam lock is snapping on the 40918-6 cane.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1531186-2015-00149
MDR Report Key4401619
Report Source*
Date Received2015-01-09
Date of Report2014-12-19
Date Facility Aware2014-12-19
Report Date2015-01-08
Date Reported to FDA2015-01-08
Date Reported to Mfgr2015-01-08
Date Added to Maude2015-01-09
Event Key0
Report Source CodeDistributor report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationPATIENT
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Single Use0
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameOFFSET HANDLE CANE - BLACK 1616710017
Generic NameTIPS AND PADS, CANE, CRUTCH AND WALKE
Product CodeINP
Date Received2015-01-09
Model Number40918-6
OperatorLAY USER/PATIENT
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerUNKNOWN
Manufacturer AddressOH US


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2015-01-09

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