FDA Adverse Event Malfunction Summary report: N

SMALL BATTERY DRIVE

MDR report key: 4093512 · Received September 16, 2014

Report

Report Number
8030965-2014-01361
Event Type
Malfunction
Date Received
September 16, 2014
Report Date
August 21, 2012
Manufacturer
SYNTHES GMBH
Product Code
MOQ
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO SYNTHES SERVICE AND REPAIR FILES LEGACY REVIEW/REMEDIATION PROTOCOL-COMPLAINT HANDLING AND MDR REPORTING. DEVICE LISTED IN THIS REPORT IS USED FOR TREATMENT, NOT DIAGNOSIS. ANY ADDITIONAL INFORMATION RECEIVED REGARDING THIS EVENT AFTER FILING THIS REPORT SHALL BE FILED ON A SUPPLEMENTAL MDR. DURING PRE-REPAIR ASSESSMENT PERFORMED BY TECHNICIAN, INVESTIGATION REVEALED THE MOTOR WAS SEIZED, NO LONGER OPERATIONAL. THE CONTROL UNIT (ECU) WAS DEGRADED WITH NOTICEABLE DIRT AND RUST ON THE INSIDE. THE DEVICE WAS REPAIRED AND RETURNED TO CUSTOMER ON (B)(4) 2012. THE COMPLAINT IS INDETERMINATE. DEVICE IS NOT DISTRIBUTED IN THE UNITED STATES, BUT IS SIMILAR TO DEVICE MARKETED IN THE USA. PLACEHOLDER.

Description of Event or Problem · 1

CUSTOMER REPORTED DEVICE WAS OVERHEATING CAUSING AN OPERATIONAL FAILURE. THIS IS REPORT 1 OF 1 FOR #(B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
572562 SMALL BATTERY DRIVE MOQ SYNTHES GMBH 3716

Patients

Seq Age Sex Outcome Treatment
1