FDA Adverse Event Malfunction Summary report: N

5.5MM AGGRESSIVE PLUS CUTTER, FORMULA (5BX)

MDR report key: 1644549 · Received March 10, 2010

Report

Report Number
2648666-2010-00148
Event Type
Malfunction
Date Received
March 10, 2010
Date of Event
March 9, 2010
Report Date
March 10, 2010
Manufacturer
STRYKER ENDOSCOPY PUERTO RICO
Product Code
FZT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TN, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WILL BE PROVIDED ONCE INVESTIGATION IS COMPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CUSTOMER HAD METAL FLAKING IN 4 OF THEIR LAST 5 SHOULDER PROCEDURES. ALLEGEDLY, THE SHAVER ALMOST APPEARS TO STUTTER OR SKIP. IT WAS FURTHER REPORTED THAT DIFFERENT HANDPIECES, FOOTPEDALS AND TPS CONSOLES WERE USED AND THE METAL IS STILL BEING SEEN.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 5.5MM AGGRESSIVE PLUS CUTTER, FORMULA (5BX) CUTTER FZT STRYKER ENDOSCOPY PUERTO RICO 10015CE2

Patients

Seq Age Sex Outcome Treatment
1 UNK