FDA Adverse Event Malfunction Summary report: N

COMPACT AIR DRIVE II

MDR report key: 4102339 · Received September 19, 2014

Report

Report Number
8030965-2014-01455
Event Type
Malfunction
Date Received
September 19, 2014
Report Date
February 7, 2013
Manufacturer
SYNTHES GMBH
Product Code
HWE
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
BR
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, IT WAS REVEALED THAT THE INVERSE TRIGGER WAS BLOCKED, THE DEVICE LACKS LUBRICATION, AND IS DIRTY DUE TO LACK OF CLEANING. THE DEVICE WAS REPAIRED AND RETURNED TO THE CUSTOMER ON (B)(6) 2013. PLACEHOLDER.

Description of Event or Problem · 1

NO ERROR DESCRIPTION WAS SENT WITH THE RETURNED DEVICE. DURING THE INSPECTION THE TECHNICIAN NOTED THE MOTOR HAS THE INVERSE TRIGGER BLOCKED. THIS IS REPORT 1 OF 1 FOR COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
584188 COMPACT AIR DRIVE II HWE SYNTHES GMBH 1903

Patients

Seq Age Sex Outcome Treatment
1