FDA Adverse Event Malfunction Summary report: N

SELECTOR 35KHZ NEURO HANDPIECE

MDR report key: 2241025 · Received August 17, 2011

Report

Report Number
8010219-2011-00015
Event Type
Malfunction
Date Received
August 17, 2011
Report Date
August 17, 2011
Manufacturer
INTEGRA, ANDOVER
Product Code
LFL
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

TO DATE, THE DEVICE INVOLVED IN THE REPORTED INCIDENT HAS BEEN RECEIVED FOR EVALUATION. AN INVESTIGATION HAS BEEN INITIATED BASED UPON THE REPORTED INFORMATION.

Description of Event or Problem · 1

PRIOR TO INCISION, THE SCRUB TECHNICIAN INSPECTED THE HAND PIECE AND NOTICED THE EXPOSED WIRES AT THE END OF THE HAND PIECE HOUSING. IT WAS STARTING TO PULL AWAY. THERE WAS NO PATIENT CONTACT OR INJURY. ANOTHER HAND PIECE WAS USED INSTEAD.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SELECTOR 35KHZ NEURO HANDPIECE NA LFL INTEGRA, ANDOVER

Patients

Seq Age Sex Outcome Treatment
1