FDA Adverse Event Malfunction Summary report: N

ADJUSTABLE PIN COLLET

MDR report key: 2150304 · Received June 7, 2011

Report

Report Number
1811755-2011-02036
Event Type
Malfunction
Date Received
June 7, 2011
Date of Event
May 9, 2011
Report Date
May 12, 2011
Manufacturer
STRYKER INSTRUMENTS KALAMAZOO
Product Code
GET
PMA / PMN Number
K943323
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MT, US
Reporter Occupation
UNKNOWN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS RETURNED TO THE MANUFACTURER FOR INVESTIGATION. BASED ON THE QUALITY INVESTIGATION, THE IMPREGLON COATING ON THE DEVICE WAS WORN OFF. THIS CONDITION COULD CAUSE THE DEVICE TO STICK, AND NOT ALLOW THE COLLET TO RELEASE THE PIN.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE PINS WERE STICKING IN THE DEVICE DURING A PROCEDURE. THE ACCOUNT HAD A BACK UP ON HAND TO COMPLETE THE CASE WITH NO ALLEGATION OF ADVERSE CONSEQUENCES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ADJUSTABLE PIN COLLET GET STRYKER INSTRUMENTS KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1 UNK