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 2017-01-16 for UNKNOWN_INSTRUMENTSTIRE_PRODUCT UNK_ICO manufactured by Stryker Instruments-kalamazoo.

Event Text Entries

[65347946] A follow up report will be filed once the quality investigation is complete.
Patient Sequence No: 1, Text Type: N, H10


[65347947] It was reported that during service conducted at the manufacturer a broken bur was found inside the attachment. It was also reported that this event did not occur during a surgical procedure and there was no delay or adverse consequences as a result of this event.
Patient Sequence No: 1, Text Type: D, B5


[67450207] Disassembly and visual inspection of the associated device (b)(4) noted the driveshaft assembly was damaged. This may have potentially caused the reported event as damage may limit the design function of the device. The affected driveshaft assembly was replaced and the drill repaired. As the bur could not be identified and that only a partial piece of a bur was returned, further evaluation of this partial piece of bur was not possible.
Patient Sequence No: 1, Text Type: N, H10


[67450208] It was reported that during service conducted at the manufacturer a broken bur was found inside the attachment. It was also reported that this event did not occur during a surgical procedure and there was no delay or adverse consequences as a result of this event.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001811755-2017-00062
MDR Report Key6253169
Date Received2017-01-16
Date of Report2017-02-15
Date of Event2016-12-20
Date Mfgr Received2017-02-03
Date Added to Maude2017-01-16
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. UNA BARRY
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
Product CodeDZJ
Date Received2017-01-16
Returned To Mfg2016-12-19
Catalog NumberUNK_ICO
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 2017-01-16

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