BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    90° CONTRA ANGLE ATTACHMENT

    MDR report key: 4172796 · Received October 15, 2014

    Report

    Report Number
    1045834-2014-14449
    Event Type
    Malfunction
    Date Received
    October 15, 2014
    Report Date
    June 18, 2013
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    HBC
    PMA / PMN Number
    PK011444
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    JA
    Reporter Occupation
    OTHER

    Narratives

    Additional Manufacturer Narrative · 1

    ADDITIONAL NARRATIVE: SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO SYNTHES 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. ADD'L PRO CODE: ERL. DURING SERVICE, TECHNICIAN FOUND THAT THE DEVICE WAS VIBRATING.

    Description of Event or Problem · 1

    CUSTOMER REPORTED THAT THE DEVICE DID NOT WORK PROPERLY.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    653728 90° CONTRA ANGLE ATTACHMENT MOTOR, DRILL, ELECTRIC - ATTACHMENT HBC DEPUY SYNTHES POWER TOOLS

    Patients

    Seq Age Sex Outcome Treatment
    1