FDA Adverse Event Malfunction Summary report: N

HCI S&N POW/POW MAX

MDR report key: 7244887 · Received February 6, 2018

Report

Report Number
1221934-2018-50142
Event Type
Malfunction
Date Received
February 6, 2018
Date of Event
January 8, 2018
Report Date
January 8, 2018
Manufacturer
DEPUY MITEK
Product Code
HRX
PMA / PMN Number
K954465
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
NY, US
Reporter Occupation
HEALTH PROFESSIONAL

Narratives

Additional Manufacturer Narrative · 1

PRODUCT COMPLAINT # (B)(4). IF INFORMATION IS OBTAINED THAT WAS NOT AVAILABLE FOR THE INITIAL MEDWATCH, A FOLLOW-UP MEDWATCH WILL BE FILED AS APPROPRIATE.¿ INVESTIGATION SUMMARY: THE COMPLAINT DEVICE IS NOT BEING RETURNED, THEREFORE IS UNAVAILABLE FOR A PHYSICAL EVALUATION. FURTHERMORE, NO LOT NUMBERS WERE SUPPLIED WHICH PRECLUDES CONDUCTING A BATCH HISTORY REVIEW OR A LOT SPECIFIC SEARCH IN THE COMPLAINTS HANDLING SYSTEM. THEREFORE, WE CANNOT DETERMINE WHAT CAUSED THE USER TO EXPERIENCE THE REPORTED EVENT, WE CANNOT DISCERN A ROOT CAUSE FOR THE REPORTED FAILURE MODE. AT THIS POINT IN TIME, NO CORRECTIVE ACTION IS REQUIRED AND NO FURTHER ACTION IS WARRANTED. HOWEVER, DEPUY MITEK WILL CONTINUE TO TRACK ANY RELATED COMPLAINTS WITHIN THIS DEVICE FAMILY AS A MEANS OF MONITORING THE EXTENT WITH WHICH THIS COMPLAINT IS OBSERVED IN THE FIELD. ASSOCIATED MEDWATCH#: 1221934-2018-50143 AND 1221934-2018-50138.

Description of Event or Problem · 1

IT WAS REPORTED BY THE SALES REP THAT THREE OF THE CUSTOMER'S 4220-3 HCI S&N POW/POW MAX -NS WERE NOT SWITCHING TO SUCTION WHEN THE SHAVERS WERE ACTIVATED DURING TESTING. THERE WAS NO PATIENT OR CASE INVOLVEMENT. THE SALES REP COULD NOT PROVIDE ANY SERIAL NUMBERS. THE DEVICES WERE DISCARDED BY THE CUSTOMER.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
87531 HCI S&N POW/POW MAX LINE-POWERED SHAVER SYSTEM HANDPIECE ELECTRICAL CABLE HRX DEPUY MITEK UNK

Patients

Seq Age Sex Outcome Treatment
1