FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 1924657 · Received December 9, 2010

Report

Report Number
1811755-2010-01979
Event Type
Malfunction
Date Received
December 9, 2010
Date of Event
November 19, 2010
Report Date
November 19, 2010
Manufacturer
STRYKER INSTRUMENTS KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE HANDPIECE WAS RECEIVED AT THE MFR FOR EVAL, AND THE REPORTED CONDITION OF THE DEVICE OVERHEATING WAS DUPLICATED. BASED ON THE INVESTIGATION DETAILS, THE LIKELY CAUSE WAS PROBLEMS WITH BEARINGS, WHICH WERE REPLACED ALONG WITH OTHER COMPONENTS. SERVICE DID A CLEAN, LUBE, AND ADJUST TO THE DEVICE, AND IT WAS REPAIRED AND RETURNED TO THE CUSTOMER.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE HANDPIECE BEGAN OVERHEATING DURING AN EXTRACTION. THE PROCEDURE WAS SUCCESSFULLY COMPLETED WITH ANOTHER DEVICE. THERE WERE NO ADVERSE CONSEQUENCES REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 CORE IMPACTION DRILL SURGICAL INSTRUMENT MOTORS AND ACCESSORIES/ATTAC DZJ STRYKER INSTRUMENTS KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1 UNK