FDA Adverse Event Malfunction Summary report: N

MA-D20

MDR report key: 4182781 · Received October 17, 2014

Report

Report Number
1045834-2014-14143
Event Type
Malfunction
Date Received
October 17, 2014
Report Date
May 13, 2013
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HBE
PMA / PMN Number
PK042783
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
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 WAS REPAIRED AND RETURNED TO THE CUSTOMER.

Description of Event or Problem · 1

THE CUSTOMER RETURNED THE DEVICE REPORTING THE ATTACHMENT WAS HEATING DURING AN OPERATION. (B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
662161 MA-D20 DRILLS, BURRS, TREPHINES HBE DEPUY SYNTHES POWER TOOLS 050000263991

Patients

Seq Age Sex Outcome Treatment
1