FDA Adverse Event
Malfunction
Summary report: N
XMAX MOTOR
MDR report key: 3042884
·
Received April 4, 2013
Report
- Report Number
- 1045834-2013-01356
- Event Type
- Malfunction
- Date Received
- April 4, 2013
- Date of Event
- March 12, 2013
- Report Date
- March 12, 2013
- Manufacturer
- THE ANSPACH EFFORT, INC.
- Product Code
- ERL
- PMA / PMN Number
- NA
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- AZ, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE DEVICE HAS BEEN RECEIVED BY ANSPACH. THE EVENT COULD NOT BE CONFIRMED. IF ADDITIONAL INFORMATION IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SENT.
Description of Event or Problem · 1
REPORT RECEIVED FROM THE USA STATING THAT DURING PRETESTING SET UP 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 ADDITIONAL INFORMATION PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 139076 | XMAX MOTOR | ERL | THE ANSPACH EFFORT, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |