FDA Adverse Event Malfunction Summary report: N

XMAX MOTOR

MDR report key: 3042454 · Received April 3, 2013

Report

Report Number
1045834-2013-01277
Event Type
Malfunction
Date Received
April 3, 2013
Date of Event
March 11, 2013
Report Date
March 11, 2013
Manufacturer
THE ANSPACH EFFORT, INC.
Product Code
ERL
PMA / PMN Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED BY ANSPACH. THE EVENT COULD NOT BE CONFIRMED. IF ADD'L INFO IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SENT.

Description of Event or Problem · 1

REPORT RECEIVED FROM THE USA STATING DURING A ROUTINE INSPECTION PERFORMED BY THE REPORTER, THE DEVICE WAS "OVERHEATING AND GETTING WARM TO THE TOUCH." THE DEVICE WAS NOT USED IN SURGERY. THERE WERE NO INJURIES OR MEDICAL INTERVENTION REPORTED. THERE WAS NO ADD'L INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
136895 XMAX MOTOR ERL THE ANSPACH EFFORT, INC.

Patients

Seq Age Sex Outcome Treatment
1