FDA Adverse Event Malfunction Summary report: N

SYSTEM 5 SAGITTAL SAW

MDR report key: 2758203 · Received September 18, 2012

Report

Report Number
1811755-2012-03538
Event Type
Malfunction
Date Received
September 18, 2012
Date of Event
August 24, 2012
Report Date
August 27, 2012
Manufacturer
STRYKER INSTRUMENTS, INSTRUMENTS DIV.
Product Code
KIJ
PMA / PMN Number
K972367
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SF
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ADD¿L INFO WILL BE SUBMITTED WHEN THE MFR INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE BACK NUT WAS MISSING WHILE THE EQUIPMENT WAS BEING INSPECTED AT THE STRYKER FOREIGN SUBSIDIARY. THERE WAS NO PT INVOLVEMENT. THERE WERE NO ADVERSE CONSEQUENCES REPORTED AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 SYSTEM 5 SAGITTAL SAW KIJ STRYKER INSTRUMENTS, INSTRUMENTS DIV.

Patients

Seq Age Sex Outcome Treatment
1 UNK