FDA Adverse Event Malfunction Summary report: N

SMALL BATTERY DRIVE

MDR report key: 3930969 · Received July 13, 2014

Report

Report Number
8030965-2014-10396
Event Type
Malfunction
Date Received
July 13, 2014
Report Date
June 16, 2014
Manufacturer
SYNTHES OBERDORF
Product Code
HWE
PMA / PMN Number
PEXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

DEVICE WAS USED FOR TREATMENT, NOT DIAGNOSIS. DEVICE IS AN INSTRUMENT AND IS NOT IMPLANTED/EXPLANTED. (B)(6). THE INVESTIGATION COULD NOT BE COMPLETED; NO CONCLUSION COULD BE DRAWN, AS NO PRODUCT WAS RECEIVED. IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.

Additional Manufacturer Narrative · 1

SERVICE HISTORY REVIEW OF THE DEVICE HAS BEEN PERFORMED. THE REVIEW INDICATES THAT THE DEVICE HAS NOT BEEN SERVICED DURING THE PAST 6 MONTHS. THERE IS NO INFORMATION RELEVANT TO THE CURRENT COMPLAINT ISSUE. THE INVESTIGATION IS BASED ON THE SERVICE & REPAIR RECORD (SRR) RECEIVED. THE DEVICE FAILURE REPORTED BY THE CUSTOMER COULD BE CONFIRMED. THE SERVICE HISTORY REVIEW SHOWS NO PREVIOUS SERVICE CONDITIONS RELEVANT TO THE CURRENT COMPLAINT ISSUE. THE SERVICE TECHNICIAN NOTED THE FOLLOWING ACTION TAKEN: UNREPAIRED RETURN. AS SEVERAL SPARE PARTS ARE LISTED ON THE SRR AMONGST OTHERS MOTOR UNIT AND ELECTRONIC CONTROL UNIT, THE DEVICE APPEARS TO BE RETURNED REPAIRED AND SERVICED ACCORDING WITH THE SERVICE & REPAIR PROCEDURE (B)(4). DURING THE PRE-REPAIR DIAGNOSTIC ASSESSMENT THE SERVICE TECHNICIAN IDENTIFIED THE FOLLOWING FAILURE: MOTOR SEIZED, ROUGH RUNNING, DEFECT. ADDITIONAL SRR FAILURE DESCRIPTION: MOTOR FAILED, MOST RELEVANT REPLACED SPARE PARTS: SEAL SET, BEARING SET, MOTOR, ECU. THE MOTOR UNIT AND ELECTRONIC CONTROL UNIT WAS REPLACED. THE PROBABLE ROOT CAUSE OF THE EVENT WAS DETERMINED TO BE NORMAL WEAR. THE DEVICE WAS RETURNED TO THE CUSTOMER 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

DEVICE REPORT FROM SYNTHES (B)(4) REPORTS AN EVENT IN (B)(6) AS FOLLOWS: IT WAS REPORTED THE SAW MODE OF THE DEVICE STOPS WORKING AS SOON AS PRESSURE IS APPLIED. THIS IS REPORT 1 OF 1 FOR (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
408987 SMALL BATTERY DRIVE INSTRUMENT, SURGICAL, ORTHOPEDIC, AC-POWERED MOTOR AND ACCESSORY/ATTACHMENT HWE SYNTHES OBERDORF

Patients

Seq Age Sex Outcome Treatment
1