FDA Adverse Event Malfunction Summary report: N

DRILL/BURR ATTACHMENT FOR 2.35MM SHAFTS

MDR report key: 3135244 · Received May 29, 2013

Report

Report Number
8030965-2013-02380
Event Type
Malfunction
Date Received
May 29, 2013
Date of Event
April 30, 2013
Report Date
April 30, 2013
Manufacturer
SYNTHES GMBH
Product Code
HWE
PMA / PMN Number
K043310
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THIS DEVICE IS USED FOR TREATMENT, NOT DIAGNOSIS. ADDITIONAL PRODUCT CODES AND COMMON DEVICE NAMES: DZI - DRILL, BONE, POWERED; ERL - DRILL, SURGICAL, ENT, HANDPIECE; HBE - DRILLS, BURRS, TREPHINES AND ACCESSORIES. INVESTIGATION IS ON GOING; NO CONCLUSION COULD BE DRAWN AS NO DEVICE WAS RETURNED. THE MANUFACTURING DOCUMENTS WERE REVIEWED AND NO COMPLAINT RELATED ISSUES WERE FOUND.

Description of Event or Problem · 1

DISTRIBUTOR REPORTS DURING A MOLAR EXTRACTION PROCEDURE, THE BURR ATTACHMENT WOULD NOT SECURE INTO THE DRILL AND THE BEARING IN THE FRONT IS LOOSE. NO ADDITIONAL INFORMATION WAS PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
236950 DRILL/BURR ATTACHMENT FOR 2.35MM SHAFTS INSTRU, SURGICAL, ORTHOPEDIC,AC, POWERED HWE SYNTHES GMBH 1452

Patients

Seq Age Sex Outcome Treatment
1