BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    XMAX MOTOR

    MDR report key: 3032948 · Received March 29, 2013

    Report

    Report Number
    1045834-2013-01033
    Event Type
    Malfunction
    Date Received
    March 29, 2013
    Date of Event
    February 7, 2011
    Report Date
    February 7, 2011
    Manufacturer
    THE ANSPACH EFFORT, INC.
    Product Code
    ERL
    PMA / PMN Number
    NA
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    NY, US
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

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

    Description of Event or Problem · 1

    THE REPORT RECEIVED FROM THE USA STATING THAT THERE WAS "SMOKE COMING FROM DRILL." THE DEVICE WAS 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
    130675 XMAX MOTOR ERL THE ANSPACH EFFORT, INC.

    Patients

    Seq Age Sex Outcome Treatment
    1