FDA Adverse Event Malfunction Summary report: N

XMAX MOTOR

MDR report key: 4130632 · Received September 30, 2014

Report

Report Number
1045834-2014-12899
Event Type
Malfunction
Date Received
September 30, 2014
Date of Event
September 16, 2014
Report Date
September 16, 2014
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
ERL
PMA / PMN Number
PK965080
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
SERVICE AND TESTING PERSONNEL

Narratives

Additional Manufacturer Narrative · 1

THE ACTUAL DEVICE WAS RETURNED FOR EVALUATION. RELIABILITY ENGINEERING EVALUATED THE DEVICE AND OBSERVED THAT THE DEVICE HAD LOW ROTATIONS PER MINUTE. IT WAS DETERMINED THAT THIS WAS DUE TO DEBRIS NOT ALLOWING THE PAWS TO CLOSE AND LOCK A CUTTER DEVICE. THE ASSIGNABLE ROOT CAUSE WAS DETERMINED TO BE DUE TO IMPROPER CLEANING, BY ALLOWING DEBRIS TO BUILD UP AND INTERFERE WITH THE LOCKING MECHANISM, WHICH IS MISUSE, ABUSE AND/OR USER ERROR. IF ADDITIONAL INFORMATION SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED ACCORDINGLY.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING ENGINEERING EVALUATION, IT WAS OBSERVED THAT THE MOTOR DEVICE HAD LOW POWER. IT WAS REPORTED THAT THIS EVENT IS NOT RELATED TO SURGERY. THERE WAS NO PATIENT INVOLVEMENT. THERE WERE NO REPORTS OF INJURIES, MEDICAL INTERVENTION OR PROLONGED HOSPITALIZATION. ALL AVAILABLE INFORMATION HAS BEEN DISCLOSED. IF ADDITIONAL INFORMATION SHOULD BECOME AVAILABLE, A SUPPLEMENTAL MEDWATCH REPORT WILL BE SUBMITTED ACCORDINGLY.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
608826 XMAX MOTOR DRILL, SURGICAL, ENT (PNEUMATIC) - HANDPIECE ERL DEPUY SYNTHES POWER TOOLS NA

Patients

Seq Age Sex Outcome Treatment
1