FDA Adverse Event
Malfunction
Summary report: N
MICROMAX-PLUS MOTOR ASSY
MDR report key: 3811855
·
Received October 11, 2013
Report
- Report Number
- 1045834-2013-04000
- Event Type
- Malfunction
- Date Received
- October 11, 2013
- Date of Event
- August 15, 2011
- Report Date
- August 16, 2011
- Manufacturer
- DEPUY SYNTHES POWER TOOLS
- Product Code
- ERL
- PMA / PMN Number
- K965080
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- NH, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
THE DEVICE HAS BEEN RECEIVED BY DEPUY SYNTHES POWER TOOLS. THE INVESTIGATION IS STILL IN PROCESS. WHEN THE INVESTIGATION HAS BEEN COMPLETED OR ADDITIONAL INFORMATION BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4). NO FILES ATTACHED.
Description of Event or Problem · 1
REPORT RECEIVED FROM USA STATING THAT THE DEVICE HAS A "INTERMITTENT OPERATION." THE DEVICE WAS BEING USED DURING SURGERY. NO INJURY OR MEDICAL INTERVENTION OCCURRED. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 523768 | MICROMAX-PLUS MOTOR ASSY | DRILL, SURGICAL, ENT - HANDPIECE | ERL | DEPUY SYNTHES POWER TOOLS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |