BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MDA ASSEMBLY

    MDR report key: 3811856 · Received October 11, 2013

    Report

    Report Number
    1045834-2013-03998
    Event Type
    Malfunction
    Date Received
    October 11, 2013
    Date of Event
    July 3, 2012
    Report Date
    July 5, 2012
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    HBC
    PMA / PMN Number
    K011444
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    CA, 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 "CAN NOT SECURE CUTTER." 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
    523792 MDA ASSEMBLY MOTOR, DRILL, ELECTRIC - ATTACHMENT HBC DEPUY SYNTHES POWER TOOLS

    Patients

    Seq Age Sex Outcome Treatment
    1