FDA Adverse Event Malfunction Summary report: N

SYSTEM 6 SAGITTAL SAW

MDR report key: 3925604 · Received July 10, 2014

Report

Report Number
0001811755-2014-02450
Event Type
Malfunction
Date Received
July 10, 2014
Date of Event
June 12, 2014
Report Date
June 12, 2014
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
HWE
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE REPORTED DISASSEMBLY WAS CONFIRMED BY A MANUFACTURER REPAIR TECHNICIAN THROUGH VISUAL INSPECTION. UPON DISASSEMBLY, IT WAS FOUND THAT THE BARREL WAS FRACTURED AT THE LEVER MOUNT, WHICH CAN LEAD TO THE REPORTED EVENT, AND CAN BE CAUSED BY A MATERIAL FATIGUE ISSUE OR IMPACT.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING TESTING CONDUCTED AT THE MANUFACTURER FACILITY THE BLADE MOUNT LEVER OF THE DEVICE DISASSEMBLED. NO MEDICAL INTERVENTION AND NO ADVERSE CONSEQUENCES WERE REPORTED WITH THIS EVENT. AS THIS EVENT OCCURRED DURING TESTING AT THE MANUFACTURER FACILITY, THERE WAS NO PATIENT INVOLVEMENT AND NO DELAY TO A SURGICAL PROCEDURE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
404697 SYSTEM 6 SAGITTAL SAW INSTRUMENT, SURGICAL, ORTHOPEDIC, AC-POWERED MOTOR AND ACCESSORY/ATTACHMENT HWE STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1