FDA Adverse Event Malfunction Summary report: N

3.5MM RESECTOR CUTTER, FORMULA (5BX)

MDR report key: 2870532 · Received November 14, 2012

Report

Report Number
2648666-2012-00357
Event Type
Malfunction
Date Received
November 14, 2012
Date of Event
October 17, 2012
Report Date
October 18, 2012
Manufacturer
STRYKER ENDOSCOPY PUERTO RICO
Product Code
HRX
PMA / PMN Number
K941333
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ADD'L INFO WILL BE PROVIDED ONCE THE INVESTIGATION HAS BEEN COMPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING AN ARTHROSCOPY PROCEDURE, THE BLADE UNIT BROKE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 3.5MM RESECTOR CUTTER, FORMULA (5BX) HRX STRYKER ENDOSCOPY PUERTO RICO 12212CE2

Patients

Seq Age Sex Outcome Treatment
1 UNK