FDA Adverse Event Malfunction Summary report: N

UNKNOWN_INSTRUMENTSTIRE_PRODUCT

MDR report key: 3901999 · Received June 30, 2014

Report

Report Number
0001811755-2014-02311
Event Type
Malfunction
Date Received
June 30, 2014
Date of Event
June 14, 2014
Report Date
June 16, 2014
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
GFF
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
OR, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE IS AVAILABLE FOR RETURN. A FOLLOW UP REPORT WILL BE FILED ONCE THE QUALITY INVESTIGATION IS COMPLETE. DEVICE NOT YET RETURNED TO MANUFACTURER.

Additional Manufacturer Narrative · 1

THE DEVICE WAS RETURNED. THE QUALITY INVESTIGATION IS COMPLETE.

Description of Event or Problem · 1

IT WAS REPORTED PRIOR TO THE CASE THE DRILL BIT BROKE OFF INSIDE OF THE ATTACHMENT. THERE WERE NO ADVERSE CONSEQUENCES OR SURGICAL DELAY AS A RESULT OF THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED PRIOR TO THE CASE THE DRILL BIT BROKE OFF INSIDE OF THE ATTACHMENT. THERE WERE NO ADVERSE CONSEQUENCES OR SURGICAL DELAY AS A RESULT OF THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
380040 UNKNOWN_INSTRUMENTSTIRE_PRODUCT UNKNOWN GFF STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1 (B)(4) LOT 13356| (B)(4) LOT 13356