MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a distributor report with the FDA on 2016-02-15 for C-LEG KNEE JOINT 3C88-2 manufactured by Otto Bock Healthcare Products Gmbh.
[38227650]
Patient was walking on the street when the c-leg became suddenly free on stance phase (no more breaks) and she fell. No injuries.
Patient Sequence No: 1, Text Type: D, B5
Report Number | 9615892-2016-00003 |
MDR Report Key | 5436160 |
Report Source | DISTRIBUTOR |
Date Received | 2016-02-15 |
Date of Report | 2016-02-10 |
Date Mfgr Received | 2016-01-29 |
Device Manufacturer Date | 2014-06-02 |
Date Added to Maude | 2016-02-15 |
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 | OTHER HEALTH CARE PROFESSIONAL |
Health Professional | 3 |
Initial Report to FDA | 3 |
Report to FDA | 3 |
Event Location | 3 |
Manufacturer Contact | MR. REINHARD WOLKERSTORFER |
Manufacturer Street | BREHMSTRASSE 16 |
Manufacturer City | VIENNA, VIENNA 1110 |
Manufacturer Country | AU |
Manufacturer Postal | 1110 |
Manufacturer G1 | OTTO BOCK HEALTHCARE PRODUCTS GMBH |
Manufacturer Street | BREHMSTRASSE 16 |
Manufacturer City | VIENNA, VIENNA 1110 |
Manufacturer Country | AU |
Manufacturer Postal Code | 1110 |
Single Use | 3 |
Previous Use Code | 3 |
Event Type | 3 |
Type of Report | 3 |
Brand Name | C-LEG KNEE JOINT |
Generic Name | EXTERNAL ABOVE KNEE PROSTHESIS |
Product Code | ISW |
Date Received | 2016-02-15 |
Returned To Mfg | 2015-11-10 |
Model Number | 3C88-2 |
Operator | LAY USER/PATIENT |
Device Availability | R |
Device Eval'ed by Mfgr | Y |
Device Sequence No | 1 |
Device Event Key | 0 |
Manufacturer | OTTO BOCK HEALTHCARE PRODUCTS GMBH |
Manufacturer Address | BREHMSTRASSE 16 VIENNA, VIENNA 1110 AU 1110 |
Patient Number | Treatment | Outcome | Date |
---|---|---|---|
1 | 0 | 2016-02-15 |