BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    12.4CM HEAVY DUTY LONG ATTCH

    MDR report key: 3970326 · Received December 11, 2013

    Report

    Report Number
    1045834-2013-15952
    Event Type
    Malfunction
    Date Received
    December 11, 2013
    Date of Event
    June 21, 2012
    Report Date
    June 21, 2012
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    HBC
    PMA / PMN Number
    K011444
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, 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.

    Description of Event or Problem · 1

    REPORT RECEIVED FROM THE USA STATING THAT THE DEVICE "CANNOT ATTACH TO MOTOR". IT IS KNOWN THAT DEVICE WAS BEING USED DURING SURGERY, BUT NO PATIENT OR USER INJURY OCCURRED. IT IS UNKNOWN IF A DELAY IN THE SURGICAL PROCEDURE OCCURRED AS A RESULT OF THE DEVICE ISSUE. THERE WAS NO ADDITIONAL INFORMATION PROVIDED.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    648792 12.4CM HEAVY DUTY LONG ATTCH MOTOR, DRILL, ELECTRIC - ATTACHMENT HBC DEPUY SYNTHES POWER TOOLS

    Patients

    Seq Age Sex Outcome Treatment
    1