FDA Adverse Event Malfunction Summary report: N

EMAX 2 PLUS MOTOR

MDR report key: 3161387 · Received June 11, 2013

Report

Report Number
1045834-2013-02400
Event Type
Malfunction
Date Received
June 11, 2013
Date of Event
May 14, 2013
Report Date
May 16, 2013
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HBC
PMA / PMN Number
K080802
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MO, US
Reporter Occupation
OTHER HEALTH CARE PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

THE ACTUAL DEVICE WAS RETURNED FOR EVALUATION. RELIABILITY ENGINEERING EVALUATED THE DEVICE AND THE REPORTED CONDITION WAS DUPLICATED AND CONFIRMED. EVIDENCE INDICATES THIS IS DUE TO USAGE WEAR OVER TIME. IF ADDITIONAL INFORMATION SHOULD BECOME AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT ACCORDINGLY. (B)(4).

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING PRE-TESTING, IT WAS OBSERVED THAT THE MOTOR DEVICE HAD "BROKEN RUBBER INSULATION". THE DEVICE WAS NOT USED IN SURGERY. THERE WERE NO DELAYS IN THE SURGICAL PROCEDURE AS AN IDENTICAL SPARE DEVICE WAS AVAILABLE FOR EVALUATION. NO INJURIES OR MEDICAL INTERVENTION WERE REPORTED. ALL AVAILABLE INFORMATION HAS BEEN DISCLOSED. IF ADDITIONAL INFORMATION SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED ACCORDINGLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
263351 EMAX 2 PLUS MOTOR MOTOR, DRILL, ELECTRIC- HANDPIECE HBC DEPUY SYNTHES POWER TOOLS

Patients

Seq Age Sex Outcome Treatment
1