MAUDE Adverse Event Report: STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP INSTRUMENT CLAMP, 10-16 MM; NEUROLOGICAL STEREOTAXIC INSTRUMENT

Model Number	8000-060-013
Medical Device Problem Codes	Incorrect Measurement (1383); Unintended Movement (3026)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	06/09/2023
Type of Reportable Event	Malfunction
Event or Problem Description
Per the customer, it was reported that the clamp was not holding equipment properly which could lead to an inaccuracy.The procedure was completed successfully without a surgical delay; no medical intervention or adverse consequences were reported.
Additional Manufacturer Narrative
Correction: follow-up report submitted to document the device was not available for evaluation.H3 other text : device not returned.
Event or Problem Description
Per the customer, it was reported that the clamp was not holding equipment properly which could lead to an inaccuracy.The procedure was completed successfully without a surgical delay; no medical intervention or adverse consequences were reported.

• Brand Name: INSTRUMENT CLAMP, 10-16 MM
• Common Device Name: NEUROLOGICAL STEREOTAXIC INSTRUMENT
• Manufacturer (Section D): STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP; 1941 stryker way; portage MI 49002
• Manufacturer (Section G): STRYKER INSTRUMENTS-FREIBURG; boetzingerstr. 41; freiburg D-791 11; GM D-79111
• Manufacturer Contact: colette chung ; 1941 stryker way; portage, MI 49002 ; 2693237700
• MDR Report Key: 17255557
• Report Number: 3015967359-2023-01411
• Device Sequence Number: 7911521
• Product Code: HAW
• UDI-Device Identifier: 07613327413151
• UDI-Public: 07613327413151
• Combination Product (Y/N): N
• Initial Reporter Country: CA
• PMA/510(K) Number: K161491
• Number of Events Summarized: 1
• 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): 10/03/2023

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 Number: 8000-060-013
• Device Catalogue Number: 8000-060-013
• Device Lot Number: 20C700024
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 06/09/2023
• Supplement Date Received by Manufacturer: 10/03/2023
• Initial Report FDA Received Date: 07/05/2023
• Supplement Report FDA Received Date: 10/03/2023
• Was Device Evaluated by Manufacturer? (Y/N): Device Not Returned to Manufacturer
• 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 Number: 1
• Patient Sex: Unknown