FDA Adverse Event Malfunction Summary report: N

CORE IMPACTION DRILL

MDR report key: 4843414 · Received June 15, 2015

Report

Report Number
0001811755-2015-02140
Event Type
Malfunction
Date Received
June 15, 2015
Date of Event
May 21, 2015
Report Date
May 22, 2015
Manufacturer
STRYKER INSTRUMENTS-KALAMAZOO
Product Code
ERL
PMA / PMN Number
K112593
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
WA, US
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

THE COMPLAINT FOR HEAT WAS NOT CONFIRMED AS THE PRODUCT WAS NOT RECEIVED FOR EVALUATION. ATTEMPTS WERE MADE TO THE CUSTOMER FOR PRODUCT RETURN AND PRODUCT WAS NOT SENT BACK.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A SURGICAL PROCEDURE AT THE USER FACILITY, THE CORE IMPACTION DRILL WAS OVERHEATING. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITH NO CLINICALLY SIGNIFICANT DELAY, NO MEDICAL INTERVENTION, AND NO ADVERSE CONSEQUENCES REPORTED.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A SURGICAL PROCEDURE AT THE USER FACILITY, THE CORE IMPACTION DRILL WAS OVERHEATING. THE PROCEDURE WAS COMPLETED SUCCESSFULLY WITH NO CLINICALLY SIGNIFICANT DELAY, NO MEDICAL INTERVENTION, AND NO ADVERSE CONSEQUENCES REPORTED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
388685 CORE IMPACTION DRILL DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE ERL STRYKER INSTRUMENTS-KALAMAZOO

Patients

Seq Age Sex Outcome Treatment
1