| Brand Name | SD/PD SERIES LONG ANGLED 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 Key | 17425203 |
| Report Number | 3015967359-2023-01742 |
| Device Sequence Number | 14941156 |
| Product Code |
ERL
|
| UDI-Device Identifier | 04546540369970 |
| UDI-Public | 04546540369970 |
| Combination Product (Y/N) | N |
| Initial Reporter State | SC |
| Initial Reporter Country | US |
| PMA/510(K) Number | K112593 |
| 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 |
| Report Date (Section B) |
07/31/2023 |
| 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 |
Other
|
| Device Catalogue Number | 5100120472 |
| Was Device Available for Evaluation? |
No
|
| Type of Report(Section G) | Initial |
| Initial Date Received by Manufacturer | 07/21/2023 |
| Initial Report FDA Received Date | 07/31/2023 |
| Was Device Evaluated by Manufacturer? (Y/N) |
Device Not Returned to Manufacturer
|
| Date Device Manufactured | 03/23/2013 |
| 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 Number | 1 |
| Patient Sex | Unknown |