FDA Adverse Event Malfunction Summary report: N

REPAIR CORE SAG SAW

MDR report key: 1935138 · Received December 6, 2010

Report

Report Number
1811755-2010-01916
Event Type
Malfunction
Date Received
December 6, 2010
Date of Event
November 8, 2010
Report Date
November 8, 2010
Manufacturer
STRYKER INSTRUMENTS KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

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 SAGITTAL HEAD WAS CORRODED AND THE SPACER WASHER WAS WORN. THE BEARINGS, FRONT HOUSING, ALONG WITH OTHER COMPONENTS, WERE REPLACED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE HANDPIECE OVERHEATED DURING ROUTINE PREVENTATIVE MAINTENANCE TESTING BY THE MANUFACTURER. THIS DID NOT OCCUR DURING ANY SURGICAL OR MEDICAL PROCEDURE, SO THERE WAS NO PATIENT INVOLVEMENT. THERE WERE NO ADVERSE CONSEQUENCES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 REPAIR CORE SAG SAW SURGICAL INSTRUMENT MOTORS AND ACCESSORIES/ATTACHMENT DZJ STRYKER INSTRUMENTS KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1 UNK