UNKNOWN_INSTRUMENTSTIRE_PRODUCT UNK_ICO

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2015-09-24 for UNKNOWN_INSTRUMENTSTIRE_PRODUCT UNK_ICO manufactured by Stryker Instruments-kalamazoo.

Event Text Entries

[26845869] Awaiting device evaluation. A follow up report will be filed once the quality investigation is complete.
Patient Sequence No: 1, Text Type: N, H10


[26845870] It was reported during a routine field service maintenance visit, a broken blade was observed inside the handpiece saw. It was also reported that this event did not occur during a surgical procedure, and there was no patient involvement or adverse consequences as a result of this event.
Patient Sequence No: 1, Text Type: D, B5


[32660678] The potential cause of the blade brake is unknown and cannot be determined based on the information available.
Patient Sequence No: 1, Text Type: N, H10


[32660679] It was reported during a routine field service maintenance visit, a broken blade was observed inside the handpiece saw. It was also reported that this event did not occur during a surgical procedure, and there was no patient involvement or adverse consequences as a result of this event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001811755-2015-03517
MDR Report Key5099790
Date Received2015-09-24
Date of Report2015-08-28
Date of Event2015-08-28
Date Mfgr Received2015-11-30
Date Added to Maude2015-09-24
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 FDA3
Event Location3
Manufacturer ContactMR. DERVILLIA MURPHY
Manufacturer StreetINSTRUMENTS DIVISION CARRIGTWOHILL BUS. & TECH PARK
Manufacturer CityCARRIGTWOHILL 00000
Manufacturer Postal00000
Manufacturer Phone214532900
Manufacturer G1STRYKER INSTRUMENTS-IRELAND
Manufacturer StreetINSTRUMENTS DIVISION CARRIGTWOHILL BUS. & TECH PARK
Manufacturer CityCARRIGTWOHILL 00000
Manufacturer Postal Code00000
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameUNKNOWN_INSTRUMENTSTIRE_PRODUCT
Generic NameUNKNOWN
Product CodeDWI
Date Received2015-09-24
Returned To Mfg2015-09-02
Catalog NumberUNK_ICO
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Address4100 EAST MILHAM AVENUE KALAMAZOO MI 49001 US 49001


Patients

Patient NumberTreatmentOutcomeDate
10 2015-09-24

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