FDA Adverse Event Malfunction Summary report: N

6.5CM ADLT CRANI, THIN FT PLATE

MDR report key: 2901505 · Received January 3, 2013

Report

Report Number
1045834-2013-00027
Event Type
Malfunction
Date Received
January 3, 2013
Date of Event
December 1, 2012
Report Date
December 6, 2012
Manufacturer
THE ANSPACH EFFORT, INC.
Product Code
HBE
PMA / PMN Number
K080802
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RECEIVED BY ANSPACH. IF ADDITIONAL INFO IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).

Description of Event or Problem · 1

REPORT RECEIVED FROM THE USA STATING "THE ATTACHMENT RUNS ROUGH AND HEATING". THE DEVICE WAS USED DURING A "CRANIOTOMY FOR TUMOR" PROCEDURE. THERE WERE NO PT OR USER INJURIES REPORTED. THE EXACT DAY OF THE EVENT WAS UNKNOWN TO THE REPORTER. THERE WAS NO ADDITIONAL INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2171 6.5CM ADLT CRANI, THIN FT PLATE HBE THE ANSPACH EFFORT, INC.

Patients

Seq Age Sex Outcome Treatment
1