inforMED
MalfunctionIPS

ESSENTIAL LARGE BASE QUAD CANE

Received Aug 13, 2015 · Event occurred Jul 28, 2015

Report 1056127-2015-00022 · MDR key 5008575

Device

Generic name

Quad Cane

Model number

ST802-BL

Catalog number

W1302BL

Product problems

  • Fracture

Patient

UNK

  • No Consequences Or Impact To Patient

Narrative

Description of Event or Problem

THE HOME MEDICAL EQUIPMENT PROVIDER STATES THAT HE HAS NO PERSONAL INFORMATION ON THE USER FOR THIS CASH SALE QUAD CANE WHICH WAS RETURNED WITH A BROKEN SHAFT. NO INJURY WAS REPORTED AND PROVIDER IS IN PROCESS OF RETURNING UNIT FOR EVALUATION.