BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MICROMAX SYSTEM MOTORS

    MDR report key: 1081987 · Received July 22, 2008

    Report

    Report Number
    1045834-2008-00070
    Event Type
    Malfunction
    Date Received
    July 22, 2008
    Date of Event
    June 12, 2008
    Report Date
    July 22, 2008
    Manufacturer
    THE ANSPACH EFFORT, INC.
    Product Code
    HBB
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    REPORTED CONDITION OF HOSE DAMAGE WAS OBSERVED TO ACTUALLY BE A HOSE RUPTURE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 MICROMAX SYSTEM MOTORS MOTORS HBB THE ANSPACH EFFORT, INC. XMAX

    Patients

    Seq Age Sex Outcome Treatment
    1 NA