FDA Adverse Event
Malfunction
Summary report: N
UNKNOWN MIS BUR
MDR report key: 2872430
·
Received December 11, 2012
Report
- Report Number
- 9616696-2012-00326
- Event Type
- Malfunction
- Date Received
- December 11, 2012
- Date of Event
- November 15, 2012
- Report Date
- November 15, 2012
- Manufacturer
- STRYKER IRELAND LTD.
- Product Code
- HBE
- PMA / PMN Number
- K032303
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Occupation
- NOT APPLICABLE
Narratives
Additional Manufacturer Narrative · 1
THE BUR AND ATTACHMENT SUBJECT TO THIS INVESTIGATION WAS RETURNED FOR EVALUATION. IT WAS VISUALLY CONFIRMED THAT THE BUR WAS BROKEN ALONG THE SHANK. THE RETURNED BUR WAS MEASURED WHERE POSSIBLE AND ALL CRITICAL SPECIFICATIONS WERE MET. LOT NUMBER INFORMATION HAS NOT BEEN PROVIDED TO PERMIT FURTHER INVESTIGATION. THE ROOT CAUSE IS MULTI-FACTORIAL.
Description of Event or Problem · 1
IT WAS REPORTED THAT DURING TESTING CONDUCTED AT THE MANUFACTURER THAT THE BUR WAS BROKEN INSIDE THE HANDPIECE. IT WAS ALSO REPORTED THAT THERE WAS NO ADVERSE CONSEQUENCES AS A RESULT OF THIS EVENT. NO FURTHER INFORMATION WAS PROVIDED.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 1 | UNKNOWN MIS BUR | HBE | STRYKER IRELAND LTD. | UNK |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 | UNK | ATTACHMENT PART NUMBER: 5100120952, LOT # 12045 |