FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 2922603 · Received January 18, 2013

Report

Report Number
0001811755-2013-00022
Event Type
Malfunction
Date Received
January 18, 2013
Date of Event
January 2, 2013
Report Date
January 2, 2013
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
IL, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

A FOLLOW-UP REPORT WILL BE FILED WHEN THE QUALITY INVESTIGATION HAS BEEN COMPLETED.

Additional Manufacturer Narrative · 1

UPON DISASSEMBLY FOR VISUAL INSPECTION CORROSION WAS FOUND ON THE MOTOR.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CORE IMPACTION DRILL HEATED UP. THERE WERE NO REPORTED PATIENT OR USER INJURIES OR ADVERSE CONSEQUENCES.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CORE IMPACTION DRILL HEATED UP. THERE WERE NO REPORTED PATIENT OR USER INJURIES OR ADVERSE CONSEQUENCES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
28012 CORE IMPACTION DRILL DRIVER, WIRE, AND BONE DRILL, MANUAL DZJ STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1