FDA Adverse Event Malfunction Summary report: N

11 CM ANGLE ATTACHMENT QD11

MDR report key: 4182133 · Received October 17, 2014

Report

Report Number
1045834-2014-14308
Event Type
Malfunction
Date Received
October 17, 2014
Report Date
December 24, 2012
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HBC
PMA / PMN Number
PK011444
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

SYNTHES IS SUBMITTING THIS REPORT AS A RESULT OF REMEDIATION ACTIVITIES RELATED TO SYNTHES (B)(4) 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. DEVICE CAME IN FOR SERVICE AND WAS REPAIRED BY TECHNICIAN. NO FURTHER INFORMATION IS AVAILABLE.

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.

Description of Event or Problem · 1

CUSTOMER REPORTED THAT BEARINGS WERE RUNNING HOT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
660180 11 CM ANGLE ATTACHMENT QD11 MOTOR, DRILL, ELECTRIC HBC DEPUY SYNTHES POWER TOOLS

Patients

Seq Age Sex Outcome Treatment
1