BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MICROMAX-LP MOTOR ASSY

    MDR report key: 3955440 · Received December 13, 2013

    Report

    Report Number
    1045834-2013-15399
    Event Type
    Malfunction
    Date Received
    December 13, 2013
    Date of Event
    March 30, 2012
    Report Date
    March 30, 2012
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    ERL
    PMA / PMN Number
    K965080
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    SZ
    Reporter Occupation
    NOT APPLICABLE

    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 ADD'L INFO BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT.

    Description of Event or Problem · 1

    REPORT RECEIVED FROM (B)(6) STATING THAT SERVICE WAS REQUIRED FOR THE DEVICE. DURING SERVICE CUT IN DEVICE HOSE WAS NOTED. IT IS UNK IF THE DEVICE WAS USED IN SURGERY. IT IS UNK IF INJURY OR MEDICAL INTERVENTION OCCURRED. THERE WAS NO ADD;L INFO PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    654122 MICROMAX-LP MOTOR ASSY ERL DEPUY SYNTHES POWER TOOLS

    Patients

    Seq Age Sex Outcome Treatment
    1