MAUDE Adverse Event Report: STRYKER CORPORATION STRYKER PERFORMANCE SERIES; BLADE, SAW, GENERAL PLASTIC SURGERY, SURGICAL

Model Number	6113119090
Health Effect - Clinical Code	Insufficient Information (4580)
Date of Event	06/08/2022
Type of Reportable Event	Malfunction
Event or Problem Description
Left knee arthroplasty.Narrow sagittal saw blade broke while doctor was completing the femoral cut.

• Brand Name: STRYKER PERFORMANCE SERIES
• Common Device Name: BLADE, SAW, GENERAL PLASTIC SURGERY, SURGICAL
• Manufacturer (Section D): STRYKER CORPORATION; 5900 optical ct; san jose CA 95138
• MDR Report Key: 15612123
• Report Number: 15612123
• Device Sequence Number: 20462729
• Product Code: GFA
• UDI-Device Identifier: 04546540593290
• UDI-Public: (01)04546540593290(17)270401(10)22104017
• Combination Product (Y/N): N
• Initial Reporter State: VA
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: User Facility
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date (Section B): 09/29/2022
• Report Date (Section F): 09/29/2022

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 Number: 6113119090
• Device Catalogue Number: 6113-119-090
• Device Lot Number: 22104017
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Was the Report Sent to FDA?: Yes
• Event Location: Hospital
• Date Report to Manufacturer: 10/14/2022
• Initial Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 10/14/2022
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Usage of Device: Unknown
• Patient Sequence Number: 1
• Patient Sex: Female
• Date Report Sent to FDA: 09/29/2022