MAUDE MDR 7889997

MDR report key
7889997
Report number
0001831750-2018-01037
Event key
0
Event type
3
Date of event
2018-08-23
Date received
2018-09-19
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
MR. BRIAN THOMPSON
Address
3800 EAST CENTRE AVENUE PORTAGE MI 49002 US
Phone
269-269-2693
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1PRIME TC SWING-AWAY MODELCHAIR, ADJUSTABLE, MECHANICALSTRYKER MEDICAL-KALAMAZOOINN1460000000N Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12018-09-190

Event Narratives#

D

Patient 1

IT WAS REPORTED THAT THE BRAKES WERE NOT WORKING. NO PATIENT WAS AFFECTED AND NO ADVERSE CONSEQUENCE OR CLINICALLY RELEVANT DELAY IN TREATMENT WAS REPORTED.

N

Patient 1

THE CUSTOMER REQUESTED A QUOTE FOR REPAIR VS PURCHASING A NEW PRIME TC. THE CUSTOMER THEN DECIDED TO PURCHASE A NEW PRIME TC INSTEAD OF A VISUAL AND FUNCTIONAL INSPECTION AND REPAIR. THEREFORE, A VISUAL AND FUNCTIONAL INSPECTION HAS NOT BEEN PERFORMED BY A STRYKER FIELD SERVICE TECHNICIAN. THE CUSTOMER CANCELED THE EVALUATION.

D

Patient 1

IT WAS REPORTED THAT THE BRAKES WERE NOT WORKING. NO PATIENT WAS AFFECTED AND NO ADVERSE CONSEQUENCE OR CLINICALLY RELEVANT DELAY IN TREATMENT WAS REPORTED.