FDA Adverse Event Malfunction Summary report: N

LOANER CORE UNIVERSAL DRIVER

MDR report key: 4760147 · Received May 8, 2015

Report

Report Number
0001811755-2015-01678
Event Type
Malfunction
Date Received
May 8, 2015
Date of Event
April 14, 2015
Report Date
April 14, 2015
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
ERL
PMA / PMN Number
K112593
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
MI, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE WAS REPAIRED AND PLACED BACK INTO STRYKER STOCK.

Description of Event or Problem · 1

THE LOANER CORE UNIVERSAL DRIVER WAS RETURNED TO STRYKER INSTRUMENTS FOR SERVICE. DURING FUNCTIONAL TESTING BY A SERVICE TECHNICIAN, IT WAS FOUND THAT THE DEVICE EXPERIENCED UNINTENTIONAL RUNNING. 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
303165 LOANER CORE UNIVERSAL DRIVER DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE ERL STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1