BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    EMAX 1 PLUS MOTOR

    MDR report key: 3020749 · Received March 18, 2013

    Report

    Report Number
    1045834-2013-00756
    Event Type
    Malfunction
    Date Received
    March 18, 2013
    Date of Event
    July 5, 2012
    Report Date
    July 5, 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 WAS 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 USA STATING THE DEVICE WAS MAKING "NOISE AND NOT HOLDING THE LONG ATTACHMENT". THE DEVICE WAS BEING USED DURING KNEE SURGERY. NO PATIENT OR USER INJURIES WERE REPORTED. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    111998 EMAX 1 PLUS MOTOR HBC THE ANSPACH EFFORT, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1