FDA Adverse Event Malfunction Summary report: Y

DUAL SPEED CEMENT INJECTION GUN

MDR report key: 19820467 · Received July 24, 2024

Report

Report Number
3015967359-2024-01391
Event Type
Malfunction
Date Received
July 24, 2024
Date of Event
June 30, 2024
Report Date
October 25, 2024
Manufacturer
STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP
Product Code
JDZ
UDI-DI
04546540039620
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 NOT 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 NOT AVAILABLE FOR EVALUATION.

Description of Event or Problem · 0

THIS REPORT SUMMARIZES 1 MALFUNCTION EVENT IN WHICH THE DEVICE WAS SHEDDING METAL DEBRIS. - 1 EVENT HAD PATIENT INVOLVEMENT; NO PATIENT IMPACT.

Description of Event or Problem · 0

THIS REPORT SUMMARIZES 1 MALFUNCTION EVENT IN WHICH THE DEVICE WAS SHEDDING METAL DEBRIS. - 1 EVENT HAD PATIENT INVOLVEMENT; NO PATIENT IMPACT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
358168 DUAL SPEED CEMENT INJECTION GUN MIXER, CEMENT, FOR CLINICAL USE JDZ STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP 04546540039620

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown