FDA Adverse Event
Malfunction
Summary report: N
XMAX MOTOR
MDR report key: 3000049
·
Received March 8, 2013
Report
- Report Number
- 1045834-2013-00611
- Event Type
- Malfunction
- Date Received
- March 8, 2013
- Report Date
- March 2, 2011
- Manufacturer
- THE ANSPACH EFFORT, INC.
- Product Code
- ERL
- PMA / PMN Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CH
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE DEVICE WAS 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 THE "MOTOR WAS VERY NOISY AND HEATING." THE DEVICE WAS NOT BEING USED DURING A PROCEDURE. NO PATIENT OR USER INJURIES WERE REPORTED. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 98866 | XMAX MOTOR | ERL | THE ANSPACH EFFORT, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |