FDA Adverse Event Malfunction Summary report: N

MINIMAL ACCESS ATTACHMENT

MDR report key: 3162187 · Received June 11, 2013

Report

Report Number
1045834-2013-02383
Event Type
Malfunction
Date Received
June 11, 2013
Date of Event
May 16, 2013
Report Date
May 16, 2013
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HBE
PMA / PMN Number
K042783
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE ACTUAL DEVICE WAS RECEIVED FOR EVALUATION. RELIABILITY ENGINEERING EVALUATED THE DEVICE AND THE REPORTED CONDITION WAS DUPLICATED AND CONFIRMED. EVIDENCE INDICATED THIS WAS 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 AN ATTACHMENT DEVICE "GOT VERY HOT" WHILE IN USE. IT WAS UNKNOWN TO THE REPORTER IF THE DEVICE WAS USED IN SURGERY, IF THERE WERE ANY DELAYS IN A SURGICAL PROCEDURE, OR IF A SPARE DEVICE WAS AVAILABLE. 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
261837 MINIMAL ACCESS ATTACHMENT MOTOR, DRILL, ELECTRIC-ATTACHMENTDRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE, HBE DEPUY SYNTHES POWER TOOLS

Patients

Seq Age Sex Outcome Treatment
1