FDA Adverse Event Injury Summary report: N

FORMULA SHAVER HANDPIECE (WITH BUTTONS)

MDR report key: 1991580 · Received February 7, 2011

Report

Report Number
2936485-2011-00076
Event Type
Injury
Date Received
February 7, 2011
Date of Event
January 12, 2011
Report Date
January 12, 2011
Manufacturer
STRYKER ENDOSCOPY SAN JOSE
Product Code
HRX
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
MD, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFORMATION WILL BE PROVIDED ONCE THE INVESTIGATION IS COMPLETED. A SIMILAR PRODUCT WITH SERIAL NUMBER (B)(4) WAS ALSO IMPLICATED IN THE EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT 2 DIFFERENT UNITS MALFUNCTIONED DURING SURGERY. ONE UNIT FAILED TO RECOGNIZE THE BLADE. THE OTHER UNIT SHOCKED THE DOCTOR.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 FORMULA SHAVER HANDPIECE (WITH BUTTONS) SHAVER HRX STRYKER ENDOSCOPY SAN JOSE

Patients

Seq Age Sex Outcome Treatment
1 UNK Other