FDA Adverse Event
Malfunction
Summary report: N
16CM MIN. INVASIVE ATTACHMENT
MDR report key: 3032916
·
Received March 29, 2013
Report
- Report Number
- 1045834-2013-01044
- Event Type
- Malfunction
- Date Received
- March 29, 2013
- Date of Event
- February 9, 2011
- Report Date
- February 10, 2011
- Manufacturer
- THE ANSPACH EFFORT, INC.
- Product Code
- HBC
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- CA, 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. STN# K011444.
Description of Event or Problem · 1
THE REPORT RECEIVED FROM THE USA STATING THAT THE DEVICE WAS "OVERHEATING." THE DEVICE WAS NOT BEING USED IN SURGERY. THERE WAS NO REPORTED PATIENT OR USER INJURIES. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 130662 | 16CM MIN. INVASIVE ATTACHMENT | HBC | THE ANSPACH EFFORT, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |