FDA Adverse Event Malfunction Summary report: N

APJ PIN COLLET 2.0-3.2MM

MDR report key: 2229015 · Received August 22, 2011

Report

Report Number
1811755-2011-03092
Event Type
Malfunction
Date Received
August 22, 2011
Date of Event
July 23, 2011
Report Date
July 23, 2011
Manufacturer
STRYKER INSTRUMENTS KALAMAZOO
Product Code
KIJ
PMA / PMN Number
K972367
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE MFR EVALUATED THE DEVICE AND UPON DISASSEMBLY THE IMPREGLON COATING WORN OFF THE COLLET. IMPREGLON COATING WEAR DEBRIS WILL CAUSE THE COLLET LEVER TO STICK AND NOT RELEASE AN INSERTED WIRE OR PIN. THE DEVICE IS NOT REPAIRABLE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE SMALL PIN GETS STUCK IN THE COLLET DUE TO THE IMPREGLON COATING ON THE COLLET BEING WORN OFF. THERE WAS NO PT INVOLVEMENT OR ADVERSE CONSEQUENCES RELATED TO THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 APJ PIN COLLET 2.0-3.2MM KIJ STRYKER INSTRUMENTS KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1 UNK