FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 4221648 · Received November 3, 2014

Report

Report Number
0001811755-2014-03923
Event Type
Malfunction
Date Received
November 3, 2014
Date of Event
October 13, 2014
Report Date
October 13, 2014
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
ERL
PMA / PMN Number
K112593
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE REPORTED FAILURE COULD NOT BE DUPLICATED AND NO COMPONENTS WERE IDENTIFIED WHICH WOULD HAVE LIKELY CAUSED OR CONTRIBUTED TO THE REPORTED FAILURE. THE DEVICE WAS SERVICED FOR PREVENTIVE MAINTENANCE AND RETURNED TO THE USER FACILITY.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING TESTING AT THE USER FACILITY THE CORE IMPACTION DRILL WAS OVERHEATING. AS THERE WAS NO PROCEDURE ASSOCIATED WITH THIS EVENT, THERE WAS NO PATIENT INVOLVEMENT, NO DELAY, NO MEDICAL INTERVENTION, AND NO ADVERSE CONSEQUENCES.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
702867 CORE IMPACTION DRILL DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE ERL STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1