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 |