FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 4143437 · Received October 6, 2014

Report

Report Number
0001811755-2014-03495
Event Type
Malfunction
Date Received
October 6, 2014
Date of Event
September 8, 2014
Report Date
September 9, 2014
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
ERL
PMA / PMN Number
K112593
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CO, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE TECHNICIAN WAS UNABLE TO CONFIRM THE REPORTED EVENT OF OVERHEATING AND NO COMPONENTS WERE IDENTIFIED WHICH WOULD CAUSE OR CONTRIBUTE TO THE REPORTED EVENT.

Additional Manufacturer Narrative · 1

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

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A CASE AT THE USER FACILITY, THE CORE IMPACTION DRILL WAS OVERHEATING. THE PROCEDURE WAS COMPLETED SUCCESSFULLY. NO DELAY, NO MEDICAL INTERVENTION, AND NO ADVERSE CONSEQUENCES WERE REPORTED WITH THIS EVENT.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A CASE AT THE USER FACILITY, THE CORE IMPACTION DRILL WAS OVERHEATING. THE PROCEDURE WAS COMPLETED SUCCESSFULLY. NO DELAY, NO MEDICAL INTERVENTION, AND NO ADVERSE CONSEQUENCES WERE REPORTED WITH THIS EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
623172 CORE IMPACTION DRILL DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE ERL STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1