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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DEPUY MITEK LLC US VAPR VUE WIRELESS FOOTSWITCH; FOOT-SWITCH, ELECTRICAL

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DEPUY MITEK LLC US VAPR VUE WIRELESS FOOTSWITCH; FOOT-SWITCH, ELECTRICAL Back to Search Results
Model Number 227214
Device Problems Break (1069); Blocked Connection (2888)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Type  malfunction  
Event Description
It was reported that during service and repair evaluation, it was determined that the vapr vue wireless footswitch device was not pairing and had a broken insert.During in-house engineering evaluation, it was determined that the device had broken inserts on the housing.There was no procedure nor patient involvement reported.No additional information was provided.
 
Manufacturer Narrative
Udi: (b)(4).Investigation summary: the complaint device was received at the service center and evaluated.It was reported that no pairing and broken insert.Per service reports, this complaint can be confirmed.During the service evaluation the following defects were identified: low batteries.Broken inserts on the housing of the unit.Minor scratches on the unit.The repair of the device was however declined, and it is being placed on long-term hold.The faulty parts were identified as the root cause for the device failure during the service evaluation.Manufacturing record evaluation is not required as the reported event is not associated with the manufacturing process and/or the potential cause of the defect cannot be associated with manufacturing.At this point in time, no corrective action is required, and no further action is warranted.Depuy mitek will continue to track any related complaints within this device family as a means of monitoring the extent to which this complaint is observed in the field.
 
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Brand Name
VAPR VUE WIRELESS FOOTSWITCH
Type of Device
FOOT-SWITCH, ELECTRICAL
Manufacturer (Section D)
DEPUY MITEK LLC US
325 paramount drive
raynham MA 02767
Manufacturer Contact
kara ditty-bovard
325 paramount drive
raynham, MA 02767
6103142063
MDR Report Key13011780
MDR Text Key282343233
Report Number1221934-2021-03757
Device Sequence Number1
Product Code GEI
UDI-Device Identifier10886705009657
UDI-Public10886705009657
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K100638
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Company Representative
Reporter Occupation Other
Type of Report Initial
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/15/2021
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number227214
Device Catalogue Number227214
Device Lot Number1704073
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/19/2021
Date Manufacturer Received12/14/2021
Was Device Evaluated by Manufacturer? Yes
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
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