FDA Adverse Event Malfunction Summary report: N

ATT ANGLED

MDR report key: 20004650 · Received August 20, 2024

Report

Report Number
1625507-2024-00352
Event Type
Malfunction
Date Received
August 20, 2024
Date of Event
July 24, 2024
Report Date
August 20, 2024
Manufacturer
MDT POWERED SURGICAL SOLUTIONS
Product Code
HBB
PMA / PMN Number
K020069
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL
Health Professional
Yes

Narratives

Additional Manufacturer Narrative · 0

H3: THE DEVICE WAS TESTED AND THE TEMPERATURE WAS MEASURED TO BE 118.94°F. THE LIKELY CAUSE OF FAILURE COULD NOT BE DETERMINED. MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.

Description of Event or Problem · 0

REPAIR REQUEST INITIATED FOR DEVICE WITH THE REPORT OF OVERHEATING. IT WAS REPORTED THERE WAS NO PATIENT INVOLVEMENT. REPAIR IS BEING ESCALATED TO PRODUCT EVENT DUE TO REASON FOR THE RETURN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2395636 ATT ANGLED MOTOR, DRILL, PNEUMATIC HBB MDT POWERED SURGICAL SOLUTIONS AA10

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown