FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 3923028 · Received July 9, 2014

Report

Report Number
0001811755-2014-02436
Event Type
Malfunction
Date Received
July 9, 2014
Date of Event
June 12, 2014
Report Date
June 12, 2014
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
DZJ
PMA / PMN Number
K040369
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
TX, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE TECHNICIAN CONFIRMED THE REPORTED EVENT OF HEATING UP AND NOTED THAT THE DRIVESHAFT BEARING WAS DAMAGED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A PROCEDURE AT THE USER FACILITY THE CORE IMPACTION DRILL WAS OVERHEATING. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITH NO DELAY; NO ADVERSE CONSEQUENCES OR MEDICAL INTERVENTION WERE REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
399399 CORE IMPACTION DRILL DRIVER, WIRE, AND BONE DRILL, MANUAL DZJ STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1