FDA Adverse Event Malfunction Summary report: N

SINGLE TRIGGER ROTARY

MDR report key: 3994345 · Received August 8, 2014

Report

Report Number
0001811755-2014-02823
Event Type
Malfunction
Date Received
August 8, 2014
Date of Event
July 15, 2014
Report Date
July 18, 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

FAILURE ANALYSIS IS IN PROGRESS; ADDITIONAL INFORMATION WILL BE SUBMITTED ONCE THE QUALITY INVESTIGATION IS COMPLETED.

Additional Manufacturer Narrative · 1

THE REPORTED DISASSEMBLY WAS CONFIRMED BY A MANUFACTURER REPAIR TECHNICIAN THROUGH VISUAL INSPECTION. UPON DISASSEMBLY, IT WAS FOUND THAT THE TRIGGER HOUSING WAS CRACKED AT THE SCREW BOSS, 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 USER FACILITY, THE TRIGGER OF THE DEVICE DISASSEMBLED. NO MEDICAL INTERVENTION AND NO ADVERSE CONSEQUENCES WERE REPORTED WITH THIS EVENT. AS THIS EVENT OCCURRED DURING TESTING, THERE WAS NO PATIENT INVOLVEMENT AND NO DELAY TO A SURGICAL PROCEDURE.

Description of Event or Problem · 1

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

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
472585 SINGLE TRIGGER ROTARY INSTRUMENT, SURGICAL, ORTHOPEDIC, AC-POWERED MOTOR AND ACCESSORY/ATTACHMENT HWE STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1