FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 2962158 · Received January 24, 2013

Report

Report Number
1811755-2013-90127
Event Type
Malfunction
Date Received
January 24, 2013
Date of Event
December 20, 2012
Report Date
December 26, 2012
Manufacturer
STRYKER INSTRUMENTS KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
NOT APPLICABLE

Narratives

Additional Manufacturer Narrative · 1

ADD'L INFO WILL BE SUBMITTED ONCE THE QUALITY INVESTIGATION HAS BEEN PERFORMED. THE REASON FOR THE SERIALIZATION STARTING WITH 90XXX IS TO PROVIDE CLARIFICATION FOLLOWING A CHANGE IN STRYKER'S ELECTRONIC COMPLAINT SYSTEMS.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A SURGICAL PROCEDURE AT THE USER FACILITY, THE DRILL WAS OVERHEATING. NO DELAY, NO MEDICAL INTERVENTION AND NO ADVERSE CONSEQUENCES WERE ALLEGED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
34872 CORE IMPACTION DRILL DZJ STRYKER INSTRUMENTS KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1 UNK