3.0MM CARBIDE MATCH HEAD 5820107530C

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2020-03-23 for 3.0MM CARBIDE MATCH HEAD 5820107530C manufactured by Stryker Instruments-kalamazoo.

Event Text Entries

[184732985] A follow up report will be filed once the quality investigation is complete. Device not returned.
Patient Sequence No: 1, Text Type: N, H10


[184732986] It was reported that during a spine fusion procedure, two burs broke at the cutting end. It was also reported that the burs had contact with metal retractors. It was further reported that there was a delay of several minutes as a result of this event. It was also reported that there were no adverse consequences as a result of this event and the procedure was completed successfully. This report is for the first bur that broke.
Patient Sequence No: 1, Text Type: D, B5


[188593223] The quality investigation is complete.
Patient Sequence No: 1, Text Type: N, H10


[188593224] It was reported that during a spine fusion procedure, two burs broke at the cutting end. It was also reported that the burs had contact with metal retractors. It was further reported that there was a delay of several minutes as a result of this event. It was also reported that there were no adverse consequences as a result of this event and the procedure was completed successfully. This report is for the first bur that broke.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0001811755-2020-00753
MDR Report Key9866828
Report SourceCOMPANY REPRESENTATIVE
Date Received2020-03-23
Date of Report2020-03-23
Date of Event2020-02-25
Date Mfgr Received2020-02-25
Device Manufacturer Date2019-11-01
Date Added to Maude2020-03-23
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 ContactMRS. UNA BARRY
Manufacturer StreetINSTRUMENTS DIVISION CARRIGTWOHILL BUS. & TECH PARK
Manufacturer CityCARRIGTWOHILL NA
Manufacturer CountryIE
Manufacturer PostalNA
Manufacturer Phone214532900
Manufacturer G1STRYKER INSTRUMENTS-IRELAND
Manufacturer StreetINSTRUMENTS DIVISION CARRIGTWOHILL BUS. & TECH PARK
Manufacturer CityCARRIGTWOHILL NA
Manufacturer CountryIE
Manufacturer Postal CodeNA
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name3.0MM CARBIDE MATCH HEAD
Generic NameDRILLS, BURRS, TREPHINES & ACCESSORIES
Product CodeHBE
Date Received2020-03-23
Model Number5820107530C
Catalog Number5820107530C
Lot Number19305017
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER INSTRUMENTS-KALAMAZOO
Manufacturer Address4100 EAST MILHAM AVENUE KALAMAZOO MI 49001 US 49001


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-23

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