MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-05-04 for HURRYCANE HCANE-BK-C2 manufactured by Jan Mao Industrial Co., Ltd.
[74445849]
Drive devilbiss healthcare is the initial importer of the device. The enduser was using the cane in a parking lot when allegedly the cane bowed at the first joint causing him to fall on his right shoulder. He was taken to the hospital for x-rays and was found to have a bruised elbow. He was sent home with no pain medication.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 2438477-2017-00036 |
| MDR Report Key | 6545797 |
| Date Received | 2017-05-04 |
| Date of Report | 2017-03-21 |
| Date of Event | 2016-10-26 |
| Date Facility Aware | 2017-03-21 |
| Report Date | 2007-04-18 |
| Date Reported to FDA | 2007-04-18 |
| Date Reported to Mfgr | 2017-04-18 |
| Date Added to Maude | 2017-05-04 |
| 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 | PATIENT |
| 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 | HURRYCANE |
| Generic Name | CANE |
| Product Code | IPS |
| Date Received | 2017-05-04 |
| Model Number | HCANE-BK-C2 |
| Operator | LAY USER/PATIENT |
| Device Availability | Y |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | JAN MAO INDUSTRIAL CO., LTD |
| Manufacturer Address | PINGGUO COUNTY INDUSTRIAL ZONE BAISE CITY, GUANGXI 531400 CH 531400 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2017-05-04 |