FDA Adverse Event Malfunction Summary report: Y

AUTOPLEX SYSTEM W/ VERTAPLEX HVV

MDR report key: 15107792 · Received July 26, 2022

Report

Report Number
3015967359-2022-01519
Event Type
Malfunction
Date Received
July 26, 2022
Date of Event
June 30, 2022
Report Date
October 24, 2022
Manufacturer
STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP
Product Code
JDZ
UDI-DI
37613252039250
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THIS RECORD IS A CONSOLIDATION OF RECORDS SUMMARIZED AS A PART OF THE FDA VOLUNTARY MALFUNCTION SUMMARY REPORTING PROGRAM. REPORTED EVENTS: 1 EVENT WAS REPORTED FOR THIS QUARTER. PRODUCT RETURN STATUS: 1 DEVICE INVESTIGATION TYPE HAS NOT YET BEEN DETERMINED. ADDITIONAL INFORMATION: 1 DEVICE WAS LABELED FOR SINGLE-USE. 1 DEVICE WAS NOT REPROCESSED OR REUSED.

Additional Manufacturer Narrative · 0

THIS RECORD IS A CONSOLIDATION OF RECORDS SUMMARIZED AS A PART OF THE FDA VOLUNTARY MALFUNCTION SUMMARY REPORTING PROGRAM. SUPPLEMENTAL RATIONALE 1 PREVIOUSLY REPORTED EVENT IS INCLUDED IN THIS FOLLOW-UP RECORD. PRODUCT RETURN STATUS 1 DEVICE WAS RECEIVED.

Description of Event or Problem · 0

THIS REPORT SUMMARIZES 1 MALFUNCTION EVENT IN WHICH THE DEVICE HAD DEBRIS IN STERILE PACKAGE. - 1 EVENT HAD PATIENT INVOLVEMENT; NO PATIENT IMPACT.

Description of Event or Problem · 0

THIS REPORT SUMMARIZES 1 MALFUNCTION EVENT IN WHICH THE DEVICE HAD DEBRIS IN STERILE PACKAGE.1 EVENT HAD PATIENT INVOLVEMENT; NO PATIENT IMPACT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1355829 AUTOPLEX SYSTEM W/ VERTAPLEX HVV MIXER, CEMENT, FOR CLINICAL USE JDZ STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP VMSR 37613252039250

Patients

Seq Age Sex Outcome Treatment
1 Unknown