FDA Adverse Event Malfunction Summary report: N

EMAX 2 PLUS MOTOR

MDR report key: 3063205 · Received April 11, 2013

Report

Report Number
1045834-2013-01589
Event Type
Malfunction
Date Received
April 11, 2013
Date of Event
March 19, 2013
Report Date
March 19, 2013
Manufacturer
THE ANSPACH EFFORT, INC.
Product Code
HBC
PMA / PMN Number
K080802
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 THE EVENT WAS DUPLICATED. EVIDENCE INDICATES THIS WAS DUE TO EXCESSIVE FORCE. THE EVENT WAS CONFIRMED. IF ADD'L INFO IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).

Description of Event or Problem · 1

REPORT RECEIVED FROM THE USA STATING THAT DURING ROUTINE INSPECTION, THE DEVICE WAS "OVERHEATING." 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
154173 EMAX 2 PLUS MOTOR HBC THE ANSPACH EFFORT, INC.

Patients

Seq Age Sex Outcome Treatment
1