FDA Adverse Event
Malfunction
Summary report: N
14CM ANGLE ATTACHMENT
MDR report key: 3042460
·
Received April 3, 2013
Report
- Report Number
- 1045834-2013-01271
- Event Type
- Malfunction
- Date Received
- April 3, 2013
- Date of Event
- March 7, 2013
- Report Date
- March 7, 2013
- Manufacturer
- THE ANSPACH EFFORT, INC.
- Product Code
- ERL
- PMA / PMN Number
- K011444
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- FL, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE DEVICE HAS BEEN RECEIVED BY ANSPACH. THE DEVICE WAS EVALUATED AND EXCEEDED TEMPERATURE LIMITS IN THE ELBOW AND BASE. EVIDENCE SUGGESTS THIS WAS DUE TO USAGE/ WEAR OVER TIME. THE EVENT WAS 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 MAINTENANCE INSPECTION THE DEVICE WAS FOUND TO BE "RUNNING HOT." THE DEVICE WAS NOT BEING USED DURING 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 |
|---|---|---|---|---|---|---|---|
| 136896 | 14CM ANGLE ATTACHMENT | ERL | THE ANSPACH EFFORT, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |