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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP CORE MOTOR CONTROLLER; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE

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STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP CORE MOTOR CONTROLLER; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE Back to Search Results
Model Number 5400050000
Medical Device Problem Code Overheating of Device (1437)
Health Effect - Clinical Codes Insufficient Information (4580); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/05/2022
Type of Reportable Event Malfunction
Event or Problem Description
The user facility reported that the device overheated.Although requested, there was no information available regarding patient involvement, delay, medical intervention, and adverse consequences.
 
Additional Manufacturer Narrative
Device evaluation: follow-up report submitted to document device evaluation results.
 
Event or Problem Description
The user facility reported that the device overheated.Although requested, there was no information available regarding patient involvement, delay, medical intervention, and adverse consequences.
 
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Brand Name
CORE MOTOR CONTROLLER
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
Manufacturer (Section G)
STRYKER INSTRUMENTS-KALAMAZOO
4100 east milham avenue
kalamazoo MI 49001
Manufacturer Contact
colette chung
1941 stryker way
portage, MI 49002
2693237700
MDR Report Key15315943
Report Number3015967359-2022-01700
Device Sequence Number5230712
Product Code ERL
UDI-Device Identifier07613153011781
UDI-Public07613153011781
Combination Product (Y/N)N
Initial Reporter StateVA
Initial Reporter CountryUS
PMA/510(K) Number
K112593
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 10/10/2022
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 Health Professional
Device Model Number5400050000
Device Catalogue Number5400050000
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 08/05/2022
Supplement Date Received by Manufacturer10/06/2022
Initial Report FDA Received Date08/29/2022
Supplement Report FDA Received Date10/10/2022
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/15/2008
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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