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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-KALAMAZOO INSTRUMENT TRACKER; NEUROLOGICAL STEREOTAXIC INSTRUMENT

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STRYKER INSTRUMENTS-KALAMAZOO INSTRUMENT TRACKER; NEUROLOGICAL STEREOTAXIC INSTRUMENT Back to Search Results
Catalog Number 6007-008-000
Medical Device Problem Code Disassembly (1168)
Health Effect - Clinical Code No Consequences Or Impact To Patient (2199)
Date of Event 05/30/2018
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during the service evaluation at the manufacturer facility, the device's battery compartment was found broken off.As this event occurred during the service evaluation process at the manufacturer facility, there was no patient involvement and no delay to a surgical procedure.
 
Additional Manufacturer Narrative
Device evaluation: follow-up report submitted to document device evaluation results.
 
Event or Problem Description
It was reported that during the service evaluation at the manufacturer facility, the device's battery compartment was found broken off.As this event occurred during the service evaluation process at the manufacturer facility, there was no patient involvement and no delay to a surgical procedure.
 
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Brand Name
INSTRUMENT TRACKER
Common Device Name
NEUROLOGICAL STEREOTAXIC INSTRUMENT
Manufacturer (Section D)
STRYKER INSTRUMENTS-KALAMAZOO
4100 east milham avenue
kalamazoo MI 49001
MDR Report Key7637525
Report Number0001811755-2018-01094
Device Sequence Number1556067
Product Code HAW
UDI-Device Identifier04546540392091
UDI-Public04546540392091
Combination Product (Y/N)N
PMA/510(K) Number
K993239
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source company representative
Initial Reporter Occupation Biomedical Engineer
Type of Report Initial,Followup
Report Date (Section B) 07/11/2018
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 Number6007-008-000
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/09/2018
Initial Date Received by Manufacturer 05/30/2018
Supplement Date Received by Manufacturer07/11/2018
Initial Report FDA Received Date06/26/2018
Supplement Report FDA Received Date07/11/2018
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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