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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-KALAMAZOO SYSTEM 5 SINGLE TRIGGER ROTARY HANDPIECE; INSTRUMENT, SURGICAL, ORTHOPEDIC, DC-POWERED MOTOR AND ACCESSORY/ATTACHMENT

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STRYKER INSTRUMENTS-KALAMAZOO SYSTEM 5 SINGLE TRIGGER ROTARY HANDPIECE; INSTRUMENT, SURGICAL, ORTHOPEDIC, DC-POWERED MOTOR AND ACCESSORY/ATTACHMENT Back to Search Results
Catalog Number 4203000000
Device Problem Smoking (1585)
Patient Problem No Patient Involvement (2645)
Event Date 03/04/2015
Event Type  malfunction  
Event Description
It was reported during service at manufacturer facility that the device is smoking.This event occurred during service therefore, no associated procedure, no patient involvement, no delay, no medical intervention and no adverse consequences were reported with this event.
 
Manufacturer Narrative
The reported event, handpiece started smoking, was duplicated.Upon disassembly, a non-stryker motor and asic motor controller were found.All non-conforming parts were replaced along with other suggested components and the device was returned to the customer after passing the final inspection.
 
Event Description
It was reported during service at manufacturer facility that the device is smoking.This event occurred during service therefore, no associated procedure, no patient involvement, no delay, no medical intervention and no adverse consequences were reported with this event.
 
Manufacturer Narrative
The device has been received, failure analysis is in progress; additional information will be submitted once the quality investigation is completed.Failure analysis is ongoing.
 
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Brand Name
SYSTEM 5 SINGLE TRIGGER ROTARY HANDPIECE
Type of Device
INSTRUMENT, SURGICAL, ORTHOPEDIC, DC-POWERED MOTOR AND ACCESSORY/ATTACHMENT
Manufacturer (Section D)
STRYKER INSTRUMENTS-KALAMAZOO
4100 east milham avenue
kalamazoo MI 49001
Manufacturer (Section G)
STRYKER INSTRUMENTS-KALAMAZOO
4100 east milham avenue
kalamazoo MI 49001
Manufacturer Contact
casey metzger
4100 east milham avenue
kalamazoo, MI 49001
2693237700
MDR Report Key4633631
MDR Text Key18925835
Report Number0001811755-2015-01117
Device Sequence Number1
Product Code KIJ
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K112593
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 03/04/2015
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/25/2015
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Catalogue Number4203000000
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/03/2015
Is the Reporter a Health Professional? No
Date Manufacturer Received04/09/2015
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured12/04/2006
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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