FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 3233757 · Received July 18, 2013

Report

Report Number
0001811755-2013-01674
Event Type
Malfunction
Date Received
July 18, 2013
Date of Event
June 27, 2013
Report Date
June 27, 2013
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

UPON DISASSEMBLY FOR VISUAL INSPECTION CORROSION WAS FOUND ON THE MOTOR PINS. A BEARING WAS BROKEN, THE ROTOR COUPLER WAS WORN AND THE MOTOR HOUSING WAS BENT.

Description of Event or Problem · 1

WHILE TESTING THE CORE IMPACTION DRILL AT THE MANUFACTURER IT WAS REPORTED THAT THE DEVICE HEATED UP. THERE WAS NO PATIENT INVOLVEMENT OR ADVERSE CONSEQUENCES REPORTED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
334394 CORE IMPACTION DRILL DRIVER, WIRE, AND BONE DRILL, MANUAL DZJ STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1