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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP ELITE 17CM STRAIGHT ATTACHMENT; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE, POWERED)

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STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP ELITE 17CM STRAIGHT ATTACHMENT; DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE, POWERED) Back to Search Results
Model Number 5407-120-485
Medical Device Problem Code Flaked (1246)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/31/2022
Type of Reportable Event Malfunction
Event or Problem Description
This report summarizes 10 malfunction events in which the device had paint chips missing.10 events had no patient involvement; no patient impact.
 
Additional Manufacturer Narrative
This record is a consolidation of records summarized as a part of the fda voluntary malfunction summary reporting program.Reported events 10 events were reported for this quarter.Product return status 10 devices were evaluated in the field.Additional information 10 devices were not labeled for single-use.10 devices were not reprocessed or reused.
 
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Brand Name
ELITE 17CM STRAIGHT ATTACHMENT
Common Device Name
DRILLS, BURRS, TREPHINES & ACCESSORIES (SIMPLE, POWERED)
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 Key16262036
Report Number3015967359-2023-00298
Device Sequence Number4135965
Product Code HBE
UDI-Device Identifier07613327096613
UDI-Public07613327096613
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
Number of Events Summarized10
Summary Report (Y/N)Y
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 01/29/2023
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
Device Model Number5407-120-485
Device Catalogue Number5407120485
Was Device Available for Evaluation? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 12/31/2022
Initial Report FDA Received Date01/29/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
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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