BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    BLACKMAX SYSTEM MOTOR

    MDR report key: 538586 · Received March 24, 2004

    Report

    Report Number
    1045834-2004-00269
    Event Type
    Malfunction
    Date Received
    March 24, 2004
    Date of Event
    January 16, 2004
    Report Date
    March 19, 2004
    Manufacturer
    THE ANSPACH EFFORT, INC.
    Product Code
    HBB
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Occupation
    OTHER

    Narratives

    Description of Event or Problem · 1

    CUSTOMER CLAIMED THE MOTOR DOES NOT ROTATE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 BLACKMAX SYSTEM MOTOR MOTOR HBB THE ANSPACH EFFORT, INC. BLACKMAX-N-LP A60377

    Patients

    Seq Age Sex Outcome Treatment
    1 *