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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: SYNTHES OBERDORF POWER MODULE FOR TRAUMA RECON SYSTEM; BATTERY, REPLACEMENT, RECHARGEABLE

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SYNTHES OBERDORF POWER MODULE FOR TRAUMA RECON SYSTEM; BATTERY, REPLACEMENT, RECHARGEABLE Back to Search Results
Catalog Number 05.001.202
Device Problem Mechanical Problem (1384)
Patient Problem No Patient Involvement (2645)
Event Date 05/20/2015
Event Type  malfunction  
Manufacturer Narrative
(b)(4).The actual device was returned for evaluation.Reliability engineering evaluated the device and the reported condition was confirmed.The assignable root cause was determined to be due to normal wear.If information is obtained that was not available for the initial medwatch, a follow-up medwatch will be filed as appropriate.
 
Event Description
It was reported from (b)(6) that during service and repair, it was observed that the power module device had vibration damage.This event was not related to surgery.There was no patient involvement.There were no reports of injuries, medical intervention or prolonged hospitalization.All available information has been disclosed.If additional information should become available, a supplemental medwatch report will be submitted accordingly.
 
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Brand Name
POWER MODULE FOR TRAUMA RECON SYSTEM
Type of Device
BATTERY, REPLACEMENT, RECHARGEABLE
Manufacturer (Section D)
SYNTHES OBERDORF
eimattstrasse 3
oberdorf CH443 6
SZ  CH4436
Manufacturer (Section G)
SYNTHES OBERDORF
eimattstrasse 3
oberdorf CH443 6
SZ   CH4436
Manufacturer Contact
linda plews
1302 wrights lane east
west chester, PA 19380
6107195000
MDR Report Key5581052
MDR Text Key43634379
Report Number8030965-2016-12852
Device Sequence Number1
Product Code MOQ
Combination Product (y/n)N
Reporter Country CodeNL
PMA/PMN Number
PEXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative,foreig
Reporter Occupation Service and Testing Personnel
Type of Report Initial
Report Date 05/20/2015
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number05.001.202
Device Lot NumberN/A
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/20/2015
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 05/20/2015
Initial Date FDA Received04/15/2016
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured01/30/2013
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage N
Patient Sequence Number1
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