FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 3233946 · Received July 18, 2013

Report

Report Number
0001811755-2013-01686
Event Type
Malfunction
Date Received
July 18, 2013
Date of Event
July 1, 2013
Report Date
July 1, 2013
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
GA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

UPON INSPECTION THE DEVICE HAD A CORRODED MOTOR SOCKET.

Additional Manufacturer Narrative · 1

DEVICE NOT YET RECEIVED. EVALUATION IS ANTICIPATED UPON RECEIPT OF DEVICE AND A FOLLOW-UP WILL BE FILED. INVESTIGATION IS IN PROGRESS. A FOLLOW-UP REPORT WILL BE SUBMITTED ONCE THE QUALITY INVESTIGATION HAS BEEN COMPLETED.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CORE IMPACTION DRILL HEATED UP DURING A CASE. THERE WAS NO PATIENT OR USER INJURY REPORTED AND NO ADVERSE CONSEQUENCES ALLEGED WITH THIS EVENT. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITH A BACKUP DEVICE.

Description of Event or Problem · 1

IT WAS REPORTED THAT THE CORE IMPACTION DRILL HEATED UP DURING A CASE. THERE WAS NO PATIENT OR USER INJURY REPORTED AND NO ADVERSE CONSEQUENCES ALLEGED WITH THIS EVENT. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITH A BACKUP DEVICE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
334983 CORE IMPACTION DRILL DRIVER, WIRE, AND BONE DRILL, MANUAL DZJ STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1