FDA Adverse Event
Malfunction
Summary report: N
ANSPACH® XMAX
MDR report key: 4170654
·
Received October 14, 2014
Report
- Report Number
- 1045834-2014-14027
- Event Type
- Malfunction
- Date Received
- October 14, 2014
- Report Date
- February 5, 2013
- Manufacturer
- DEPUY SYNTHES POWER TOOLS
- Product Code
- ERL
- PMA / PMN Number
- PK131053
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SF
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
DURING PRE-REPAIR ASSESSMENT PERFORMED BY TECHNICIAN, IT WAS NOTED THAT THE LOCKING COMPONENTS WERE DAMAGED. DEVICE WAS INSPECTED AND REPAIRED.
Description of Event or Problem · 1
CUSTOMER REPORTED DRILL LOSES POWER. THIS IS REPORT 1 OF 1 FOR EVENT #COM-(B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 651488 | ANSPACH® XMAX | DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE | ERL | DEPUY SYNTHES POWER TOOLS |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |