FDA Adverse Event
Malfunction
Summary report: N
EMAX 2 PLUS MOTOR
MDR report key: 3060739
·
Received April 5, 2013
Report
- Report Number
- 1045834-2013-01293
- Event Type
- Malfunction
- Date Received
- April 5, 2013
- Report Date
- November 14, 2011
- Manufacturer
- THE ANSPACH EFFORT, INC.
- Product Code
- HBC
- PMA / PMN Number
- K080802
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- TX, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE DEVICE WAS RECEIVED BY ANSPACH. IF ADD'L INFO IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).
Description of Event or Problem · 1
THE REPORT RECEIVED FROM THE USA STATING THAT THE DEVICE WAS HEATING. THE DEVICE WAS NOT BEING USED IN SURGERY. THERE WAS NO REPORTED PATIENT OR USER INJURIES. THE DATE OF THE EVENT IS UNK. THERE WAS NO ADD'L INFO PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 139986 | EMAX 2 PLUS MOTOR | HBC | THE ANSPACH EFFORT, INC. |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |