BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    8CM ANGLE ATTACHMENT

    MDR report key: 3963872 · Received December 13, 2013

    Report

    Report Number
    1045834-2013-13514
    Event Type
    Malfunction
    Date Received
    December 13, 2013
    Date of Event
    November 15, 2011
    Report Date
    November 15, 2011
    Manufacturer
    DEPUY SYNTHES POWER TOOLS, 4500 RIVERSIDE DR.
    Product Code
    HBC
    PMA / PMN Number
    K011444
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    TX, US
    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 ADDITIONAL INFORMATION BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).

    Description of Event or Problem · 1

    REPORT RECEIVED FROM THE USA STATING THAT THE DEVICE WAS "HEATING UP." THE DEVICE WAS NOT BEING USED DURING SURGERY. NO INJURIES WERE REPORTED. IT IS UNKNOWN IF MEDICAL INTERVENTION OCCURRED. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    652896 8CM ANGLE ATTACHMENT HBC DEPUY SYNTHES POWER TOOLS, 4500 RIVERSIDE DR.

    Patients

    Seq Age Sex Outcome Treatment
    1