BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    ANSPACH® MULTA

    MDR report key: 4163446 · Received October 10, 2014

    Report

    Report Number
    1045834-2014-13620
    Event Type
    Malfunction
    Date Received
    October 10, 2014
    Report Date
    February 12, 2013
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    ERL
    PMA / PMN Number
    PK131053
    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 TECHNICIAN WAS FOUND THAT BEARINGS WERE DAMAGED DUE TO STRAIN, NORMAL WEAR THE TECHNICIAN NOTICED THE BEARINGS AND COUPLINGS WERE HEAVILY WORN OUT IN THE REAR PART. BEARINGS AND COUPLINGS WERE REPLACED IN THE REAR PART.

    Description of Event or Problem · 1

    CUSTOMER REPORTED EMISSION OF UNFAMILIAR NOISE AND HEAT. REPORT 1 OF 1 COMPLAINT (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    640362 ANSPACH® MULTA DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE ERL DEPUY SYNTHES POWER TOOLS

    Patients

    Seq Age Sex Outcome Treatment
    1