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