FDA Adverse Event Malfunction Summary report: N

UNIV-BATTERY CHARGER F/SYNTHES BATT 4 CH

MDR report key: 4143477 · Received October 6, 2014

Report

Report Number
8030965-2014-01012
Event Type
Malfunction
Date Received
October 6, 2014
Report Date
May 8, 2013
Manufacturer
SYNTHES GMBH
Product Code
MOQ
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GM
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO (B)(4) AND REPAIR FILES LEGACY REVIEW/REMEDIATION PROTOCOL-COMPLAINT HANDLING AND MDR REPORTING. BLANK FIELDS ON THIS FORM INDICATE THE INFORMATION IS UNKNOWN, UNAVAILABLE OR UNCHANGED. 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 POWER SUPPLY DID NOT FUNCTION PROPERLY. THIS WAS CONTRIBUTED TO NORMAL WEAR. VARIOUS PARTS WERE REPLACED. DEVICE WAS REPAIRED AND RETURNED TO THE CUSTOMER ON 05/29/2013. PLACEHOLDER.

Description of Event or Problem · 1

CUSTOMER REPORTED THAT THE LEFT SIDE OF THE CHARGER WAS FUNCTIONLESS. ALL 6 CHARGING UNITS WERE AFFECTED. THIS IS REPORT 1 OF 1 FOR COMPLAINT (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
622919 UNIV-BATTERY CHARGER F/SYNTHES BATT 4 CH MOQ SYNTHES GMBH 41159

Patients

Seq Age Sex Outcome Treatment
1