FDA Adverse Event Malfunction Summary report: N

EMAX 2 PLUS MOTOR

MDR report key: 3020783 · Received March 18, 2013

Report

Report Number
1045834-2013-00715
Event Type
Malfunction
Date Received
March 18, 2013
Report Date
July 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 DEVICE WAS "MAKING NOISE". THE DEVICE WAS BEING USED DURING SURGERY. THERE WERE NO PT OR USER INJURIES REPORTED. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
112291 EMAX 2 PLUS MOTOR HBC THE ANSPACH EFFORT, INC.

Patients

Seq Age Sex Outcome Treatment
1