FDA Adverse Event Malfunction Summary report: N

BLACKMAX-NEURO LOW PRESSURE

MDR report key: 4183319 · Received October 17, 2014

Report

Report Number
1045834-2014-14385
Event Type
Malfunction
Date Received
October 17, 2014
Report Date
October 26, 2012
Manufacturer
DEPUY SYNTHES POWER TOOLS
Product Code
HBB
PMA / PMN Number
PK831756
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
UK
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. DURING PRE-REPAIR ASSESSMENT PERFORMED BY TECHNICIAN, INVESTIGATION REVEALED THE DEVICE SPEED LOW, BLADES WERE BROKEN, HOSE CUT AND ANGLE ATTACHMENT WORN. THE DEVICE WAS REPAIRED AND RETURNED TO CUSTOMER.

Description of Event or Problem · 1

DEVICE WAS RETURNED FOR SERVICE. DURING SERVICE, TECHNICIAN FOUND DEVICE ROTATIONAL SPEED LOW, BLADES BROKEN, HOSE CUT AND ANGLE ATTACHMENT WORN. (B)(4)

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
660281 BLACKMAX-NEURO LOW PRESSURE MOTOR, DRILL, PNEUMATIC HBB DEPUY SYNTHES POWER TOOLS

Patients

Seq Age Sex Outcome Treatment
1