BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    CORE IMPACTION DRILL

    MDR report key: 2200946 · Received July 1, 2011

    Report

    Report Number
    1811755-2011-02382
    Event Type
    Malfunction
    Date Received
    July 1, 2011
    Date of Event
    June 6, 2011
    Report Date
    June 8, 2011
    Manufacturer
    STRYKER INSTRUMENTS KALAMAZOO
    Product Code
    DZJ
    PMA / PMN Number
    K040369
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    MO, US
    Reporter Occupation
    UNKNOWN

    Narratives

    Additional Manufacturer Narrative · 1

    THE DRIVESHAFT AND ROTOR WERE STUCK TOGETHER DUE TO CORROSION. ROTOR RUB WAS IDENTIFIED AS THE PROBABLE CAUSE OF THE OVERHEATING.

    Description of Event or Problem · 1

    THE CORE IMPACTION DRILL WAS SENT IN FOR EVALUATION DUE TO OVERHEATING DURING A TOOTH EXTRACTION PROCEDURE. THE PROCEDURE WAS COMPLETED WITH A READILY AVAILABLE REPLACEMENT DEVICE WITHOUT ANY PROCEDURE DELAY. NO ADVERSE EVENT WAS ASSOCIATED WITH THE DEVICE.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    1 CORE IMPACTION DRILL DZJ STRYKER INSTRUMENTS KALAMAZOO

    Patients

    Seq Age Sex Outcome Treatment
    1 UNK