FDA Adverse Event
Malfunction
Summary report: N
MICROMAX-PLUS MOTOR ASSY
MDR report key: 4182561
·
Received October 17, 2014
Report
- Report Number
- 1045834-2014-14133
- Event Type
- Malfunction
- Date Received
- October 17, 2014
- Report Date
- July 24, 2012
- Manufacturer
- DEPUY SYNTHES POWER TOOLS
- Product Code
- ERL
- PMA / PMN Number
- PK965080
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- SZ
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
ADDITIONAL NARRATIVE: 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 A TECHNICIAN, THE DEVICE WAS FOUND TO BE NOT FUNCTIONING PROPERLY AND SOME PARTS REQUIRED REPLACING; THE CAUSE IS UNDETERMINED. DEVICE WAS REPAIRED AND RETURNED TO THE CUSTOMER.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE ATTACHMENT IS HARD TO CONNECT AND THAT THE DEVICE OVERHEATED. THIS IS REPORT 1 OF 1 FOR (B)(4).
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 660224 | MICROMAX-PLUS MOTOR ASSY | DRILL, SURGICAL, ENT (PNEUMATIC) - HANDPIECE | ERL | DEPUY SYNTHES POWER TOOLS | 050000224894 |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |