VIONIC SHOES 335ADLEY/ASR-1437 OVC-A286564

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2017-10-13 for VIONIC SHOES 335ADLEY/ASR-1437 OVC-A286564 manufactured by Vionic.

Event Text Entries

[89451938] I purchased two pairs of vionic sneakers from (b)(6). On (b)(6) 2017 i tried them on to make sure i liked the fit. They did not feel right on my foot. I decided to wear them to the grocery - it would be quick and maybe could tell more about the shoes. I walked from the grocery store parking lot which is small and before i was half way into the store i had pain in my left ankle and my left knee popped, my right knee had terrible pain too but did not pop. I was hanging onto the shelving to not fall down which drew the attention from other shoppers. I needed help and rode an electric cart to my car. At this point it had not been 20 minutes since putting the shoes on at home. I had the man that makes custom prescription orthotics look at the shoes comparing them to another pair of vionic. Shoes i have. He concluded the shoes were one size smaller than marked and this put the arch support on the orthotic footbed to be located behind my arch causing my ankle/foot to rotate/roll to the outside of my body. The right shoe on both pairs were distorted in a twist causing the sole to wobble front to back. I saw a general practitioner.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5072743
MDR Report Key6947538
Date Received2017-10-13
Date of Report2017-10-10
Date of Event2017-01-19
Date Added to Maude2017-10-13
Event Key0
Report Source CodeVoluntary 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 Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Sequence Number: 1

Brand NameVIONIC SHOES
Generic NameORTHOSIS, CORRECTIVE SHOE
Product CodeKNP
Date Received2017-10-13
Model Number335ADLEY/ASR-1437
Catalog NumberOVC-A286564
Lot NumberLC: 10-26-16
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No1
Device Event Key0
ManufacturerVIONIC

Device Sequence Number: 2

Brand NameVIONIC SHOES
Generic NameORTHOSIS, CORRECTIVE SHOE
Product CodeKNP
Date Received2017-10-13
Model Number335ADLEY/ASR-1437
OperatorLAY USER/PATIENT
Device AvailabilityY
Device Eval'ed by MfgrI
Device Sequence No2
Device Event Key0
ManufacturerVIONIC


Patients

Patient NumberTreatmentOutcomeDate
101. Deathisabilit 2017-10-13

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