inforMED
MalfunctionIPS

DESIGNER QUAD CANE

Received Jan 31, 2019 · Event occurred Jan 14, 2019

Report 1056127-2019-00001 · MDR key 8292749

Device

Generic name

Quad Cane

Model number

C-604S-CD04

Catalog number

W1303I

Lot number

N/A

Product problems

  • Fracture
  • Fracture

Patient

65 YR

  • Fall
  • Fall

Narrative

Description of Event or Problem

PER DEALER, END USER WAS USING CANE NORMALLY WHEN SHAFT BROKE AND END USER FELL. NO INJURIES WERE REPORTED. DEALER REFUSED TO GIVE INFORMATION ON END USER. DATA FOR EU IS APPROXIMATE.