inforMED
InjuryIPS

DRIVE

Received Mar 26, 2020 · Event occurred Oct 1, 2019

Report 2438477-2020-00019 · MDR key 9884725

Device

Generic name

Cane

Model number

RTL10365-ADJ

Product problems

  • Fracture
  • Fracture

Patient

69 YR

  • Bruise/Contusion
  • Fall
  • Bruise/Contusion
  • Fall

Narrative

Description of Event or Problem

DRIVE DEVILBISS HEALTHCARE IS THE INITIAL IMPORTER OF THE DEVICE WHICH IS A CANE. PMS ASSOCIATE IS AWAITING RETURN OF THE DEVICE FOR EVALUATION AND PHONE INTERVIEW WITH CONSUMER FOR MORE INFORMATION. WE ARE FILING THIS REPORT IN AN OVERABUNDANCE OF CAUTION BECAUSE SHE HIT HER HEAD. END-USER WAS AT THE BANK WAITING ON LINE SITTING ON THE CANE SEAT WHEN IT BROKE. SHE FELL ON HER TAILBONE AND HIT HER HEAD ON A BIG LONG TABLE. SHE WENT TO THE EMERGENCY ROOM AND TOOK X RAYS OF HER HEAD AND TAILBONE. SHE HAD NO BREAKS BUT LARGE BRUISE THAT WERE PAINFUL.