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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP U SERIES STRAIGHT MEDIUM M" ATTACHMENT"; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE

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STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP U SERIES STRAIGHT MEDIUM M" ATTACHMENT"; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE Back to Search Results
Model Number 5100010050
Medical Device Problem Code Overheating of Device (1437)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 11/28/2022
Type of Reportable Event Malfunction
Event or Problem Description
The manufacturer field service technician reported that the device overheated while they were conducting a demonstration 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 they were conducting a demonstration at the user facility.There were no adverse consequences related to this event.
 
Additional Manufacturer Narrative
Device evaluation: follow-up report submitted to document the device was not available for evaluation.H3 other text : no product return.
 
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Brand Name
U SERIES STRAIGHT MEDIUM M" 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
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 Key16033911
Report Number3015967359-2022-02487
Device Sequence Number20241378
Product Code ERL
UDI-Device Identifier04546540074492
UDI-Public04546540074492
Combination Product (Y/N)N
Initial Reporter StateND
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) 05/16/2023
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 Other
Device Model Number5100010050
Device Catalogue Number5100010050
Device Lot Number17278
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 11/28/2022
Supplement Date Received by Manufacturer05/16/2023
Initial Report FDA Received Date12/22/2022
Supplement Report FDA Received Date05/16/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured10/05/2017
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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