FDA Adverse Event Malfunction Summary report: N

EMAX 2 PLUS MOTOR

MDR report key: 3080985 · Received April 24, 2013

Report

Report Number
1045834-2013-02027
Event Type
Malfunction
Date Received
April 24, 2013
Date of Event
March 21, 2013
Report Date
March 28, 2013
Manufacturer
THE ANSPACH EFFORT, INC.
Product Code
HBC
PMA / PMN Number
K080802
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HAS BEEN RECEIVED BY ANSPACH. THE REPORTED MALFUNCTION COULD NOT BE CONFIRMED. IF ADDITIONAL INFO IS RECEIVED, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).

Description of Event or Problem · 1

REPORT RECEIVED FROM THE USA STATING THAT THE DEVICE WAS "OVERHEATING". THE ALLEGED CONDITION WAS DISCOVERED DURING ROUTINE SERVICE INSPECTION. THE DEVICE WAS NOT USED IN SURGERY. NO INJURIES OR MEDICAL INTERVENTION WERE REPORTED. THERE WAS NO ADDITIONAL INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
176418 EMAX 2 PLUS MOTOR HBC THE ANSPACH EFFORT, INC.

Patients

Seq Age Sex Outcome Treatment
1