FDA Adverse Event Malfunction Summary report: N

BURR-ATTACHM S F/EPD+APD

MDR report key: 4192521 · Received October 22, 2014

Report

Report Number
8030965-2014-01693
Event Type
Malfunction
Date Received
October 22, 2014
Report Date
March 11, 2013
Manufacturer
SYNTHES GMBH
Product Code
HWE
PMA / PMN Number
K043310
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
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. PLACEHOLDER.

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. (B)(6). DEVICE CAME IN FOR SERVICE AND WAS REPAIRED BY TECHNICIAN. NO FURTHER INFORMATION IS AVAILABLE. PLACEHOLDER.

Description of Event or Problem · 1

CUSTOMER REPORTED AND RETURNED A DEVICE FOR REPAIR/UNDER WARRANTY. DURING SERVICE TECHNICIAN FOUND THE GEAR, BROKEN/TORN OFF; BEARINGS EXPLODED AND BLOCKED TURBINE. THIS IS REPORT 1 OF 1 FOR COMPLAINT #(B)(4).

Description of Event or Problem · 1

CUSTOMER REPORTED AND RETURNED A DEVICE FOR REPAIR/UNDER WARRANTY. THIS IS REPORT 1 OF 1 FOR COMPLAINT#(B)(4).

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
671653 BURR-ATTACHM S F/EPD+APD HWE SYNTHES GMBH 1499933

Patients

Seq Age Sex Outcome Treatment
1