SYSTEM 5 SINGLE TRIGGER ROTARY HANDPIECE 4203000000

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 2015-03-17 for SYSTEM 5 SINGLE TRIGGER ROTARY HANDPIECE 4203000000 manufactured by Stryker Instruments-kalamazoo.

Event Text Entries

[5656177] It was reported that the handpiece is stuck in on position during inspection before the procedure. No patient involvement, no delay, no medical intervention and no adverse consequences were reported with this event. After receiving at the manufacturer facility it was found that the handpiece was running without pressing the trigger.
Patient Sequence No: 1, Text Type: D, B5


[5878454] It was reported that the handpiece is stuck in on position during inspection before the procedure. No patient involvement, no delay, no medical intervention and no adverse consequences were reported with this event. After receiving at the manufacturer facility it was found that the handpiece was running without pressing the trigger.
Patient Sequence No: 1, Text Type: D, B5


[13066147] The device has been received, failure analysis is in progress; additional information will be submitted once the quality investigation is completed. Failure analysis is in progress.
Patient Sequence No: 1, Text Type: N, H10


[13330266] Device was repaired and returned after passing the final inspection.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number0001811755-2015-00966
MDR Report Key4608238
Report Source06
Date Received2015-03-17
Date of Report2015-02-18
Date of Event2015-02-10
Date Mfgr Received2015-05-15
Device Manufacturer Date2005-02-25
Date Added to Maude2015-03-17
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. CASEY METZGER
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal49001
Manufacturer Phone2693237700
Manufacturer G1STRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Street4100 EAST MILHAM AVENUE
Manufacturer CityKALAMAZOO MI 49001
Manufacturer CountryUS
Manufacturer Postal Code49001
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameSYSTEM 5 SINGLE TRIGGER ROTARY HANDPIECE
Generic NameINSTRUMENT, SURGICAL, ORTHOPEDIC, DC-POWERED MOTOR AND ACCESSORY/ATTACHMENT
Product CodeKIJ
Date Received2015-03-17
Returned To Mfg2015-02-23
Catalog Number4203000000
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 2015-03-17

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