UNKNOWN_INSTRUMENTSTIRE_PRODUCT UNK_ICO

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 2014-09-08 for UNKNOWN_INSTRUMENTSTIRE_PRODUCT UNK_ICO manufactured by Stryker Instruments-kalamazoo.

Event Text Entries

[4899611] It was reported that bur broke in the attachment. There was no medical intervention, surgical delay or adverse consequences reported as a result of this event
Patient Sequence No: 1, Text Type: D, B5


[5074811] It was reported that the bur broke in the attachment. It was reported that this happened after a case and there was no patient impact as a result of the event.
Patient Sequence No: 1, Text Type: D, B5


[12431336] The device is available for return. A follow up report will be filed once the quality investigation is complete. Product not yet returned to manufacturer.
Patient Sequence No: 1, Text Type: N, H10


[12548664] The device was returned. Quality investigation is complete.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number0001811755-2014-03178
MDR Report Key4067326
Report Source06
Date Received2014-09-08
Date of Report2014-08-12
Date of Event2014-08-12
Date Mfgr Received2014-10-29
Date Added to Maude2014-09-22
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. DERVILLIA MURPHY
Manufacturer StreetINSTRUMENTS DIVISION CARRIGTWOHILL BUS. & TECH PARK
Manufacturer CityCARRIGTWOHILL NA
Manufacturer PostalNA
Manufacturer Phone214532900
Manufacturer G1STRYKER INSTRUMENTS-IRELAND
Manufacturer StreetINSTRUMENTS DIVISION CARRIGTWOHILL BUS. & TECH PARK
Manufacturer CityCARRIGTWOHILL NA
Manufacturer Postal CodeNA
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNKNOWN_INSTRUMENTSTIRE_PRODUCT
Generic NameUNKNOWN BUR
Product CodeHTT
Date Received2014-09-08
Returned To Mfg2014-10-09
Catalog NumberUNK_ICO
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 KALAMAZOO MI 49001 US 49001


Patients

Patient NumberTreatmentOutcomeDate
10 2014-09-08

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