BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    FOOT CONTROL

    MDR report key: 4180499 · Received October 17, 2014

    Report

    Report Number
    1045834-2014-14350
    Event Type
    Malfunction
    Date Received
    October 17, 2014
    Report Date
    April 2, 2013
    Manufacturer
    DEPUY SYNTHES POWER TOOLS
    Product Code
    HBC
    PMA / PMN Number
    PK080802
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AU
    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, IT WAS NOTED THAT THE CABLE WAS DAMAGED AND THE PEDAL WAS MISSING DUE TO IMPROPER HANDLING. THE DEVICE WAS REPAIRED BY REPLACING SEVERAL COMPONENTS.

    Description of Event or Problem · 1

    THE CUSTOMER REPORTED THAT THE FOOT SWITCH NEEDS TO BE SERVICED. THIS IS REPORT 1 OF 1 FOR COMPLAINT (B)(4).

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    662850 FOOT CONTROL MOTOR, DRILL, ELECTRIC - FOOT CONTROL HBC DEPUY SYNTHES POWER TOOLS

    Patients

    Seq Age Sex Outcome Treatment
    1