FDA Adverse Event Malfunction Summary report: N

XMAX MOTO

MDR report key: 3983885 · Received December 18, 2013

Report

Report Number
1045834-2013-16128
Event Type
Malfunction
Date Received
December 18, 2013
Date of Event
October 5, 2012
Report Date
October 8, 2012
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
ERL
PMA / PMN Number
K965080
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RECEIVED BY DEPUY SYNTHES. THE DEVICE IS CURRENTLY UNDERGOING EVALUATION. ONCE THE EVALUATION HAS BEEN COMPLETED OR IF ADDITIONAL INFORMATION IS RECEIVED, A SUPPLEMENTAL MDR WILL BE SENT. REF: (B)(4).

Description of Event or Problem · 1

A REPORT WAS RECEIVED FROM THE USA, STATING THAT THE DEVICE WILL NOT LOCK THE BITS IN PLACE. THE DEVICE WAS BEING USED DURING SURGERY. THERE ALSO WAS NO REPORT OF USER OR PATIENT INJURY OR MEDICAL INTERVENTION. NO ADDITIONAL INFORMATION AVAILABLE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
663268 XMAX MOTO ERL DEPUY SYNTHES POWER TOOLS

Patients

Seq Age Sex Outcome Treatment
1