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