BIO-PREP BONE PREPARATION KIT 0206710000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 06 report with the FDA on 2013-03-28 for BIO-PREP BONE PREPARATION KIT 0206710000 manufactured by Stryker Instruments-kalamazoo.

Event Text Entries

[3325518] It was reported that the sculpt left blue flakes in the patient during a procedure. The surgeon was able to suction the all of the flakes from the surgical site without patient or user injuries, and there were no adverse consequences.
Patient Sequence No: 1, Text Type: D, B5


[3430887] It was reported that the scuplt left blue flakes in the patient during a procedure. The surgeon was able to suction the all of the flakes from the surgical site without patient or user injuries, and there were no adverse consequences.
Patient Sequence No: 1, Text Type: D, B5


[10607943] A follow up report will be filed when the device is received and the quality investigatioin has been completed. Not received by manufacturer.
Patient Sequence No: 1, Text Type: N, H10


[10733270] Upon evaluation wear was observed on the sculp.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number0001811755-2013-00648
MDR Report Key3026060
Report Source06
Date Received2013-03-28
Date of Report2013-03-04
Date of Event2013-03-04
Date Mfgr Received2013-04-11
Device Manufacturer Date2012-09-20
Date Added to Maude2013-05-08
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMR. KATE LONGMAN
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal49001
Manufacturer Phone2693237700
Manufacturer G1STRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Street4100 EAST MILHAM AVENUE HIGHWAY #3, KM 130.2
Manufacturer CityKALAMAZOO MI 49001006
Manufacturer CountryUS
Manufacturer Postal Code49001 0061
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameBIO-PREP BONE PREPARATION KIT
Generic NamePROSTHESIS, HIP, CEMENT RESTRICTOR
Product CodeJDK
Date Received2013-03-28
Returned To Mfg2012-09-20
Catalog Number0206710000
Lot Number12264012
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Address4100 EAST MILHAM AVENUE HIGHWAY #3, KM 130.2 KALAMAZOO MI 49001006 US 49001 0061


Patients

Patient NumberTreatmentOutcomeDate
10 2013-03-28

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