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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE 10MM 3-FLUTED ACORN REAMER

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STRYKER ENDOSCOPY-SAN JOSE 10MM 3-FLUTED ACORN REAMER Back to Search Results
Catalog Number 0234020010
Device Problem Material Fragmentation (1261)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/16/2024
Event Type  malfunction  
Event Description
It was reported that the device broke during the procedure.All pieces were able to be retrieved.
 
Manufacturer Narrative
Additional information will be provided once the investigation has been completed.The device manufacturer date is not known at this time.However, should it become available it will be provided in future reports.
 
Manufacturer Narrative
This complaint investigation was closed based on the device not received, therefore the reported failure mode was not confirmed.In the event that the device is received, the complaint will be reopened and the investigation will be updated with new results.Alleged failure: drill snapped.Probable root cause: design: inadequate instrument design for usage process.Instrument manufactured out of specification application.User not applying forces correctly on instrument.User applying excessive force on instrument.User does not size reamer, dilator correctly for graft and, or fixation selected.Use past expected device lifetime.The reported failure mode will be monitored for future reoccurrence.Manufacture date is not known.
 
Event Description
It was reported that the device broke during the procedure.All pieces were able to be retrieved.
 
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Brand Name
10MM 3-FLUTED ACORN REAMER
Type of Device
REAMER
Manufacturer (Section D)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
Manufacturer (Section G)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
Manufacturer Contact
lucas wolski
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key18914063
MDR Text Key337782474
Report Number0002936485-2024-00231
Device Sequence Number1
Product Code HTO
UDI-Device Identifier04546540755308
UDI-Public04546540755308
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Company Representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 08/23/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number0234020010
Device Lot NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 02/16/2024
Initial Date FDA Received03/15/2024
Supplement Dates Manufacturer Received02/16/2024
Supplement Dates FDA Received08/23/2024
Was Device Evaluated by Manufacturer? No
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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