FDA Adverse Event Malfunction Summary report: N

EMAX 2 PLUS MOTOR

MDR report key: 3011088 · Received March 14, 2013

Report

Report Number
1045834-2013-00680
Event Type
Malfunction
Date Received
March 14, 2013
Date of Event
February 13, 2013
Report Date
February 13, 2013
Manufacturer
THE ANSPACH EFFORT, INC.
Product Code
HBC
PMA / PMN Number
K080802
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OH, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED BY ANSPACH. THE DEVICE WAS EVALUATED AND THE EVENT WAS DUPLICATED. EVIDENCE INDICATES THIS IS DUE TO USAGE WEAR OVER TIME. THE EVENT WAS CONFIRMED. IF ADDITIONAL INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SENT.

Description of Event or Problem · 1

REPORT RECEIVED FROM THE USA STATING THAT THE DEVICE WAS "HEATING UP" DURING TESTING PRIOR TO SURGERY. THERE WERE NO DELAYS TO ANY SCHEDULED SURGERIES. THERE WERE NO INJURIES REPORTED. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
108553 EMAX 2 PLUS MOTOR HBC THE ANSPACH EFFORT, INC.

Patients

Seq Age Sex Outcome Treatment
1