FDA Adverse Event Malfunction Summary report: N

8CM HEAVY DUTY MEDIUM ATTACH

MDR report key: 3790675 · Received May 5, 2014

Report

Report Number
1045834-2014-11958
Event Type
Malfunction
Date Received
May 5, 2014
Date of Event
April 18, 2014
Report Date
April 18, 2014
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HBC
PMA / PMN Number
PK011444
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NC, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE ACTUAL DEVICE WAS RETURNED FOR EVALUATION. RELIABILITY ENGINEERING EVALUATED THE DEVICE. THE DEVICE WAS TESTED AND FOUND THAT THE TEMPERATURE WAS ABOVE SPECIFICATION. THEREFORE, THE REPORTED CONDITION WAS DUPLICATED AND CONFIRMED. THE BEARINGS WERE DAMAGED WHICH CAUSED THE HIGH TEMPERATURE. THE ASSIGNABLE ROOT CAUSE WAS DETERMINED TO BE NORMAL WEAR OF COMPONENT PARTS OVER TIME. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Description of Event or Problem · 1

IT WAS REPORTED THAT PRIOR TO SURGERY IT WAS DISCOVERED THAT THE ATTACHMENT DEVICE WAS HOT. THERE WERE NO DELAYS TO THE PLANNED SURGICAL PROCEDURE AS A SPARE IDENTICAL DEVICE WAS AVAILABLE FOR USE. THERE WAS NO PATIENT INVOLVEMENT REPORTED. THERE WERE NO REPORTS OF INJURIES, MEDICAL INTERVENTION OR PROLONGED HOSPITALIZATION. 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
268548 8CM HEAVY DUTY MEDIUM ATTACH MOTOR, DRILL, ELECTRIC - ATTACHMENT HBC DEPUY SYNTHES POWER TOOLS NA

Patients

Seq Age Sex Outcome Treatment
1