MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-02-23 for ENDURANCE QUAD CANE ST802-S W1302S manufactured by Combridge International Company, Ltd..
[68177478]
Patient stated that he had placed the quad cane on the ground when he noticed that the shaft felt loose. He lifted the cane and found the lower portion of the cane was hanging by a sliver of aluminium before separating completely. Prior to this incident the patient did not perceive any problems with the cane. There was no fall or injury.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 1056127-2017-00004 |
| MDR Report Key | 6354475 |
| Date Received | 2017-02-23 |
| Date of Report | 2017-02-06 |
| Date of Event | 2017-02-02 |
| Date Facility Aware | 2017-02-06 |
| Report Date | 2017-02-23 |
| Date Reported to FDA | 2017-02-23 |
| Date Reported to Mfgr | 2017-02-18 |
| Date Added to Maude | 2017-02-23 |
| Event Key | 0 |
| Report Source Code | Distributor report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | ENDURANCE QUAD CANE |
| Generic Name | QUAD CANE |
| Product Code | IPS |
| Date Received | 2017-02-23 |
| Model Number | ST802-S |
| Catalog Number | W1302S |
| Operator | LAY USER/PATIENT |
| Device Availability | Y |
| Device Age | 2 YR |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | COMBRIDGE INTERNATIONAL COMPANY, LTD. |
| Manufacturer Address | UNIT 1, NO. 66 YULONG 3 ROAD DONG SHENG TOWN ZHONG SHANG CITY, GUANGDONG 528414 CH 528414 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2017-02-23 |