BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    MDA ASSEMBLY

    MDR report key: 3960013 · Received December 13, 2013

    Report

    Report Number
    1045834-2013-07905
    Event Type
    Malfunction
    Date Received
    December 13, 2013
    Date of Event
    April 8, 2011
    Report Date
    April 8, 2011
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    HBC
    PMA / PMN Number
    K011444
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    IT
    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. REF: (B)(4).

    Description of Event or Problem · 1

    THE DEVICE WAS RECEIVED FROM ITALY FOR SERVICE. DURING SERVICE OF THE DEVICE, IT WAS FOUND TO BE VIBRATING. IT IS UNK IF THE DEVICE WAS USED DURING SURGERY. IT IS UNK IF SURGICAL DELAY OR MEDICAL INTERVENTION OCCURRED. THERE WAS NO ADD'L INFO PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    654426 MDA ASSEMBLY HBC DEPUY SYNTHES POWER TOOLS

    Patients

    Seq Age Sex Outcome Treatment
    1