FDA Adverse Event Malfunction Summary report: N

CAD II

MDR report key: 4102304 · Received September 19, 2014

Report

Report Number
8030965-2014-01466
Event Type
Malfunction
Date Received
September 19, 2014
Report Date
February 6, 2013
Manufacturer
SYNTHES GMBH
Product Code
HWE
PMA / PMN Number
EXEMPT
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 OUS 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 A TECHNICIAN, FUNCTIONAL TESTING WAS PERFORMED AND REVEALED THE MOTOR SEIZED AND JAMMED AND THE ASSEMBLY WAS FULL OF DIRT. THIS WAS ATTRIBUTED TO NORMAL WEAR. WORN AND DEGRADED PARTS WERE REPLACED AND THE DEVICE WAS REPAIRED AND RETURNED TO THE CUSTOMER ON (B)(4) 2013. PLACEHOLDER.

Description of Event or Problem · 1

CUSTOMER REPORTED THEY SUSPECT THE WELDING OF THE TRIGGER ASSEMBLY. THE UNIT DOES NOT STOP TURNING IMMEDIATELY AFTER RELEASING THE TRIGGER. IT KEEPS TURNING FOR A WHILE. THIS IS REPORT 1 OF 1 FOR COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
584101 CAD II HWE SYNTHES GMBH 22059

Patients

Seq Age Sex Outcome Treatment
1