MAUDE Adverse Event Report: SYNTHES GMBH POWER DRIVE

Catalog Number 530.100

Device Problems Device Stops Intermittently (1599); Temperature Problem (3022)

Patient Problem No Known Impact Or Consequence To Patient (2692)

Event Type  malfunction  

Event Description

Customer reported that the power drive 530.100 stopped in the middle of the sawing process.It could be used to saw again after it was shaken.The instruments hand grip got very hot.This procedure had to be repeated several times during the op.This is report 1 of 1 for complaint # (b)(4).

Manufacturer Narrative

Additional narrative: synthes is submitting this report as a result of remediation activities related to synthes 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 a technician, functional testing was performed and revealed the tool lock jams.This was attributed to normal wear.The device was repaired and returned to the customer on (b)(4) 2012.(b)(4).Placeholder.

• Brand Name: POWER DRIVE
• Manufacturer (Section D): SYNTHES GMBH; eimattstrasse 3; ch-4436; oberdorf ; SZ
• Manufacturer (Section G): SYNTHES GMBH; eimattstrasse 3; ch-4436; oberdorf ; SZ
• Manufacturer Contact: lisa plews ; 1302 wrights lane east; west chester, PA 19380 ; 8006207025
• MDR Report Key: 4034212
• MDR Text Key: 4721929
• Report Number: 8030965-2014-00835
• Device Sequence Number: 1
• Product Code: GEY
• Combination Product (y/n): N
• Reporter Country Code: GM
• PMA/PMN Number: EXEMPT
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Foreign,Health Professional
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 09/27/2012

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Date FDA Received: 08/25/2014
• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: 530.100
• Device Lot Number: 34871
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 09/27/2012
• Is the Reporter a Health Professional?: No
• Date Manufacturer Received: 09/27/2012
• Was Device Evaluated by Manufacturer?: Yes
• Date Device Manufactured: 06/12/2006
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Patient Sequence Number: 1