FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 1983974 · Received January 11, 2011

Report

Report Number
1811755-2011-00073
Event Type
Malfunction
Date Received
January 11, 2011
Date of Event
December 15, 2010
Report Date
December 15, 2010
Manufacturer
STRYKER INSTRUEMNTS KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
PA, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE HANDPIECE WAS RECEIVED AT THE MANUFACTURER FOR TESTING. AN EVALUATION WILL BE CONDUCTED, AND A FOLLOW-UP REPORT WILL BE SUBMITTED IF THE RESULTS OF THE QUALITY INVESTIGATION REQUIRE ONE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE HANDPIECE BEGAN OVERHEATING DURING AN ORAL SURGERY. THE PROCEDURE WAS COMPLETED. 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 INSTRUMETN MOTORS AND ACCESSORIES/ATTAC DZJ STRYKER INSTRUEMNTS KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1 UNK