FDA Adverse Event
Malfunction
Summary report: N
SYSTEM CONSOLE
MDR report key: 3984273
·
Received December 18, 2013
Report
- Report Number
- 1045834-2013-15873
- Event Type
- Malfunction
- Date Received
- December 18, 2013
- Date of Event
- September 2, 2011
- Report Date
- September 2, 2011
- Manufacturer
- DEPUY SYNTHES POWER TOOLS
- Product Code
- HBC
- PMA / PMN Number
- K011444
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- IA, 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 PROGRESS. WHEN THE INVESTIGATION HAS BEEN COMPLETED OR ADDITIONAL INFO BECOMES AVAILABLE, A SUPPLEMENTAL REPORT WILL BE SENT. REF: (B)(4).
Description of Event or Problem · 1
REPORT RECEIVED FROM USA STATING THAT THE DEVICE HAD AN "ERROR MESSAGE ON CONSOLE" ISSUE. THE DEVICE WAS NOT USED DURING A SURGICAL PROCEDURE. IT WAS UNK IF THERE WAS ANY PATIENT INJURY OR MEDICAL INTERVENTION OCCURRED. THERE WAS NO ADDITIONAL INFO PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 664042 | SYSTEM CONSOLE | HBC | DEPUY SYNTHES POWER TOOLS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |