FDA Adverse Event Malfunction Summary report: N

AL-III W/FOOT CONTROL

MDR report key: 3963926 · Received December 13, 2013

Report

Report Number
1045834-2013-14826
Event Type
Malfunction
Date Received
December 13, 2013
Date of Event
January 27, 2011
Report Date
January 27, 2011
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
GEY
PMA / PMN Number
K970530
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
VT, 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 ADD'L INFO BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT. (B)(4).

Description of Event or Problem · 1

REPORT RECEIVED FROM USA STATING THE DEVICE HAD A CRACKED PSI GAUGE. THE DEVICE WAS USED DURING SURGERY. NO PT INJURY REPORTED. THERE WAS NO ADD'L INFO PROVIDED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
653334 AL-III W/FOOT CONTROL GEY DEPUY SYNTHES POWER TOOLS

Patients

Seq Age Sex Outcome Treatment
1