FDA Adverse Event
Malfunction
Summary report: N
CORE IMPACTION DRILL
MDR report key: 2920710
·
Received January 17, 2013
Report
- Report Number
- 0001811755-2013-00018
- Event Type
- Malfunction
- Date Received
- January 17, 2013
- Date of Event
- December 31, 2012
- Report Date
- December 31, 2012
- Manufacturer
- STRYKER INSTRUMENTS-KALAMAZOO
- Product Code
- DZJ
- PMA / PMN Number
- K040369
- Product Problem
- Yes
- Report Source
- Manufacturer report
- Reporter Location
- RI, US
- Reporter Occupation
- OTHER
Narratives
Additional Manufacturer Narrative · 1
UPON DISASSEMBLY, IT WAS FOUND THAT THE MOTOR WAS WORN AND THE BALANCED ROTOR WAS NOT FIT PROPERLY. PREVENTATIVE MAINTENANCE WAS PERFORMED ON THE BEARINGS AND THE DEVICE WAS RETURNED TO THE USER FACILITY.
Description of Event or Problem · 1
IT WAS REPORTED THAT THE CORE IMPACTION DRILL HEATED UP DURING TESTING. THERE WAS NO PATIENT INVOLVEMENT, AND THERE WERE NO USER INJURIES OR ADVERSE CONSEQUENCES.
Devices
| Seq | Brand | Generic | Product Code | Manufacturer | Model | Lot | UDI-DI |
|---|---|---|---|---|---|---|---|
| 26361 | CORE IMPACTION DRILL | DRIVER, WIRE, AND BONE DRILL, MANUAL | DZJ | STRYKER INSTRUMENTS-KALAMAZOO |
Patients
| Seq | Age | Sex | Outcome | Treatment |
|---|---|---|---|---|
| 1 |