FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 1873413 · Received September 17, 2010

Report

Report Number
1811755-2010-01206
Event Type
Malfunction
Date Received
September 17, 2010
Date of Event
August 20, 2010
Report Date
August 23, 2010
Manufacturer
STRYKER INSTRUMENTS KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE HANDPIECE HAS BEEN RECEIVED AT THE MANUFACTURER FOR INVESTIGATION. AN EVALUATION WAS CONDUCTED AND THE COMPLAINT WAS CONFIRMED. ACCORDING TO THE INVESTIGATION DETAILS, THE ROTOR WAS WORN. THE DRIVESHAFT, ROTOR, AND SPINDLE HOUSING WERE REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE HANDPIECE OVERHEATED. AT THIS TIME, IT IS UNK IF THERE WAS PT INVOLVEMENT OR ADVERSE CONSEQUENCES ASSOCIATED WITH THIS EVENT. MULTIPLE ATTEMPTS TO GATHER ADDITIONAL INFORMATION FROM THE ACCOUNT WERE UNSUCCESSFUL.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CORE IMPACTION DRILL BONE CUTTING INSTRUMENT AND ACCESSORIES DZJ STRYKER INSTRUMENTS KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1 UNK