FDA Adverse Event Malfunction Summary report: N

EMAX 2 PLUS MOTOR

MDR report key: 3020716 · Received March 18, 2013

Report

Report Number
1045834-2013-00729
Event Type
Malfunction
Date Received
March 18, 2013
Report Date
August 10, 2012
Manufacturer
THE ANSPACH EFFORT, INC.
Product Code
HBC
PMA / PMN Number
K080802
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

REPORT RECEIVED FROM THE USA STATING THE "MOTOR WAS VERY LOUD AND RATTLING". THE DEVICE WAS BEING USED DURING KNEE SURGERY. THERE WERE NO PATIENT OR USER INJURIES REPORTED. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
111801 EMAX 2 PLUS MOTOR HBC THE ANSPACH EFFORT, INC.

Patients

Seq Age Sex Outcome Treatment
1