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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP SD/PD SERIES XL PLUS ANGLED ATTACHMENT; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE

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STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP SD/PD SERIES XL PLUS ANGLED ATTACHMENT; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE Back to Search Results
Model Number 5100120492
Medical Device Problem Code Overheating of Device (1437)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/16/2021
Type of Reportable Event Malfunction
Event or Problem Description
The manufacturer field service technician reported that the device overheated while it was being serviced at the user facility.There were no adverse consequences related to this event.
 
Event or Problem Description
The manufacturer field service technician reported that the device overheated while it was being serviced at the user facility.There were no adverse consequences related to this event.
 
Additional Manufacturer Narrative
Follow-up report submitted to document device evaluation results.
 
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Brand Name
SD/PD SERIES XL PLUS ANGLED ATTACHMENT
Common Device Name
DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE
Manufacturer (Section D)
STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP
1941 stryker way
portage MI 49002
MDR Report Key11821771
Report Number3015967359-2021-00854
Device Sequence Number14367312
Product Code ERL
UDI-Device Identifier04546540494757
UDI-Public04546540494757
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source company representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 08/13/2021
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
Operator of Device Other
Device Model Number5100120492
Device Catalogue Number5100120492
Device Lot Number13158
Was Device Available for Evaluation? Yes
Initial Date Received by Manufacturer 04/16/2021
Supplement Date Received by Manufacturer08/13/2021
Initial Report FDA Received Date05/13/2021
Supplement Report FDA Received Date08/13/2021
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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