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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-KALAMAZOO PD SERIES MAESTRO D" ATTACHMENT"; MOTOR, DRILL, PNEUMATIC

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STRYKER INSTRUMENTS-KALAMAZOO PD SERIES MAESTRO D" ATTACHMENT"; MOTOR, DRILL, PNEUMATIC Back to Search Results
Catalog Number 5400210056
Medical Device Problem Code Overheating of Device (1437)
Health Effect - Clinical Code No Consequences Or Impact To Patient (2199)
Date of Event 09/01/2018
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
This record is a consolidation of records summarized as a part of the fda voluntary malfunction summary reporting program.Reported events: 1 event was reported for this quarter.Product return status: 1 device was received for evaluation.  evaluation status: 1 device evaluation is in progress.Additional information: 1 device is not labeled for single-use.1 device was not reprocessed and reused.
 
Event or Problem Description
This report summarizes malfunction event in which the device reportedly overheated.1 event 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.  supplemental rationale corrected data: 1 event was initially reported.1 previously reported event is included in this follow-up record.  product return status 1 device was received.Evaluation status 1 reported event was confirmed during testing.- 1 device was found to be affected by internal corrosion.  additional information 1 device is not labeled for single-use.1 device was not reprocessed and reused.
 
Event or Problem Description
This report summarizes 1 malfunction event in which the device reportedly overheated.1 event had no patient involvement; no patient impact.
 
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Brand Name
PD SERIES MAESTRO D" ATTACHMENT"
Common Device Name
MOTOR, DRILL, PNEUMATIC
Manufacturer (Section D)
STRYKER INSTRUMENTS-KALAMAZOO
4100 east milham avenue
kalamazoo MI 49001
MDR Report Key8016696
Report Number0001811755-2018-02285
Device Sequence Number1370778
Product Code HBB
UDI-Device Identifier07613153014010
UDI-Public07613153014010
Combination Product (Y/N)N
Initial Reporter StateMI
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)Y
Reporter Type Manufacturer
Report Source company representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 01/31/2019
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 No Information
Device Catalogue Number5400210056
Was Device Available for Evaluation? No
Initial Date Received by Manufacturer 09/01/2018
Supplement Date Received by Manufacturer09/01/2018
Initial Report FDA Received Date10/29/2018
Supplement Report FDA Received Date01/31/2019
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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