BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    EMX 2 PLUS MOTOR

    MDR report key: 2921877 · Received January 15, 2013

    Report

    Report Number
    1045834-2013-00100
    Event Type
    Malfunction
    Date Received
    January 15, 2013
    Date of Event
    December 12, 2012
    Report Date
    December 19, 2012
    Manufacturer
    THE ANSPACH EFFORT, INC.
    Product Code
    HBC
    PMA / PMN Number
    K080802
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    THE DEVICE HAS BEEN RECEIVED BY ANSPACH. IF ADDITIONAL INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SENT.

    Description of Event or Problem · 1

    REPORT RECEIVED FROM (B)(6) STATING THAT THE DEVICE WAS "GETTING HOT AND STOPPED FUNCTIONING." THE DEVICE WAS BEING USED DURING A SPINE CASE. THE CUSTOMER CHANGED THE EQUIPMENT AND COMPLETED THE CASE. THERE WERE NO INJURIES OR MEDICAL INTERVENTION REPORTED. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    22573 EMX 2 PLUS MOTOR HBC THE ANSPACH EFFORT, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1