MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2019-01-29 for MICRO DRILL SERIES ANGLED ATTACHMENT 5100015252 manufactured by Stryker Instruments-kalamazoo.
[134462653]
This record is a consolidation of records summarized as a part of the fda voluntary malfunction summary reporting program. Reported events: 3? Events were reported for this quarter. ? Product return status: 3 devices were received. Evaluation status: confirmed 2 reported events were confirmed during testing. 2 devices were found to be affected by detached components. Not confirmed: 1 reported event was not confirmed during testing. Additional information: 3? Devices were not labeled for single-use. 3 devices were not reprocessed and reused.
Patient Sequence No: 1, Text Type: N, H10
[134462654]
This report summarizes
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0001811755-2019-00307 |
| MDR Report Key | 8284974 |
| Report Source | COMPANY REPRESENTATIVE |
| Date Received | 2019-01-29 |
| Date of Report | 2019-04-29 |
| Date of Event | 2018-12-25 |
| Date Mfgr Received | 2018-12-25 |
| Date Added to Maude | 2019-01-29 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR. ZACH BAKER |
| Manufacturer Street | 4100 EAST MILHAM AVENUE |
| Manufacturer City | KALAMAZOO MI 49001 |
| Manufacturer Country | US |
| Manufacturer Postal | 49001 |
| Manufacturer Phone | 2693237700 |
| Manufacturer G1 | STRYKER INSTRUMENTS-KALAMAZOO |
| Manufacturer Street | 4100 EAST MILHAM AVENUE |
| Manufacturer City | KALAMAZOO MI 49001 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 49001 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | MICRO DRILL SERIES ANGLED ATTACHMENT |
| Generic Name | UNIT, OPERATIVE DENTAL |
| Product Code | EIA |
| Date Received | 2019-01-29 |
| Catalog Number | 5100015252 |
| Lot Number | VMSR |
| Device Availability | N |
| Device Age | DA |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | STRYKER INSTRUMENTS-KALAMAZOO |
| Manufacturer Address | 4100 EAST MILHAM AVENUE KALAMAZOO MI 49001 US 49001 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-01-29 |