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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP CORE, SUMEX HANDSWITCH; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE

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STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP CORE, SUMEX HANDSWITCH; DRILL, SURGICAL, ENT (ELECTRIC OR PNEUMATIC) INCLUDING HANDPIECE Back to Search Results
Catalog Number 5400131000
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/03/2024
Type of Reportable Event Malfunction
Event or Problem Description
The user facility reported that pieces fell out of the device during testing at the user facility.There was no patient involvement, no delay, no medical intervention, and no adverse consequences.The handle may break into small pieces, posing the risk of a small component becoming lost in a surgical site.
 
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Brand Name
CORE, SUMEX HANDSWITCH
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
kelsey barla
1941 stryker way
portage, MI 49002
2693237700
MDR Report Key20305504
Report Number3015967359-2024-01844
Device Sequence Number21049529
Product Code ERL
UDI-Device Identifier04546540534132
UDI-Public04546540534132
Combination Product (Y/N)N
Initial Reporter StateMO
Initial Reporter CountryUS
PMA/510(K) Number
K112593
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 09/25/2024
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 Catalogue Number5400131000
Device Lot Number22298
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/06/2024
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 09/03/2024
Initial Report FDA Received Date09/25/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/25/2022
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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