FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 2851379 · Received October 29, 2012

Report

Report Number
1811755-2012-03929
Event Type
Malfunction
Date Received
October 29, 2012
Date of Event
October 5, 2012
Report Date
October 8, 2012
Manufacturer
STRYKER INSTRUMENTS KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ADDITIONAL INFO WILL BE SUBMITTED ONCE THE QUALITY INVESTIGATION IS COMPLETED, IF ADDITIONAL INFO IS RECEIVED AND REQUIRES REPORTING.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A SURGICAL PROCEDURE AT THE USER FACILITY THE DRILL WAS OVERHEATING. THE PROCEDURE WAS COMPLETED WITH THE SAME DEVICE WITHOUT A DELAY; NO ADVERSE CONSEQUENCES OR MEDICAL INTERVENTION WERE REPORTED.

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