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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP 5.5MM OVAL SOLID CARBIDE BUR MEDIUM; BUR, SURGICAL, GENERAL & PLASTIC SURGERY

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STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP 5.5MM OVAL SOLID CARBIDE BUR MEDIUM; BUR, SURGICAL, GENERAL & PLASTIC SURGERY Back to Search Results
Model Number 5300010903
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/30/2022
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during a surgical procedure that two burs broke resulting in a delay of forty minutes.The procedure was completed successfully; no adverse consequences or medical intervention were reported.This report is for the second bur that broke.
 
Additional Manufacturer Narrative
A follow up report will be filed once the quality investigation is complete.Device discarded.
 
Additional Manufacturer Narrative
H6: the quality investigation is complete.
 
Event or Problem Description
It was reported that during a surgical procedure that two burs broke resulting in a delay of forty minutes.The procedure was completed successfully; no adverse consequences or medical intervention were reported.This report is for the second bur that broke.
 
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Brand Name
5.5MM OVAL SOLID CARBIDE BUR MEDIUM
Common Device Name
BUR, SURGICAL, GENERAL & PLASTIC SURGERY
Manufacturer (Section D)
STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP
1941 stryker way
portage MI 49002
Manufacturer (Section G)
STRYKER INSTRUMENTS-IRELAND
instruments division
carrigtwohill bus. & tech park
carrigtwohill NA
EI   NA
Manufacturer Contact
una barry
instruments division
carrigtwohill bus. & tech park
carrigtwohill NA
EI   NA
214532900
MDR Report Key15963791
Report Number3015967359-2022-02430
Device Sequence Number14687217
Product Code GFF
UDI-Device Identifier07613153000624
UDI-Public07613153000624
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician Assistant
Type of Report Initial,Followup
Report Date (Section B) 03/31/2023
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 Number5300010903
Device Catalogue Number5300010903
Device Lot Number22083017
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 11/30/2022
Supplement Date Received by Manufacturer03/30/2023
Initial Report FDA Received Date12/12/2022
Supplement Report FDA Received Date03/31/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured03/24/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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