MAUDE Adverse Event Report: MEDTECH SA ROSA SURGICAL DEVICE; COMPUTER ASSISTED SURGICAL DEVICE

Model Number ROSA 2.5.8

Device Problem Degraded (1153)

Patient Problem No Patient Involvement (2645)

Event Date 02/02/2015

Event Type  malfunction  

Manufacturer Narrative

The device (b)(4) has been inspected for investigation purposes.The tests performed confirmed that a tear is present on the power cord.The defective parts were replaced for repair purposes.

Event Description

During an intervention performed on customer site by our field engineer, it was identified that the power cord was non-functional.There was no patient involvement reported.

• Brand Name: ROSA SURGICAL DEVICE
• Type of Device: COMPUTER ASSISTED SURGICAL DEVICE
• Manufacturer (Section D): MEDTECH SA; zac eureka; 900 rue du mas de verchant; montpellier, 34000 ; FR 34000
• Manufacturer (Section G): MEDTECH SA; zac eureka; 900 rue du mas de verchant; montpellier, 34000 ; FR 34000
• Manufacturer Contact: jay sharma ; zac eureka; 900 rue du mas de verchant; montpellier, 34000 ; FR 34000 ; 7414400
• MDR Report Key: 6456875
• MDR Text Key: 71630465
• Report Number: 3009185973-2017-00423
• Device Sequence Number: 1
• Product Code: HAW
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K101791
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative
• Reporter Occupation: Medical Equipment Company Technician/Representative
• Remedial Action: Replace
• Type of Report: Initial
• Report Date: 04/04/2017

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: No Information
• Device Model Number: ROSA 2.5.8
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Initial Date Manufacturer Received: 02/02/2015
• Initial Date FDA Received: 04/04/2017
• Was Device Evaluated by Manufacturer?: Yes
• Date Device Manufactured: 09/07/2010
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Reuse
• Patient Sequence Number: 1