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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE RF 2 PROBES, 90-S MAX; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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STRYKER ENDOSCOPY-SAN JOSE RF 2 PROBES, 90-S MAX; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Model Number 0279401100
Device Problem Continuous Firing (1123)
Patient Problems Insufficient Information (4580); No Clinical Signs, Symptoms or Conditions (4582)
Event Date 12/16/2022
Event Type  malfunction  
Event Description
It was reported that the device continuously activated.
 
Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Manufacturer Narrative
The product was returned for investigation and the reported failure mode was confirmed.Alleged failure: after being turned on, it was stuck on "on" and could not be used anymore.Based on the physical evidence during the investigation, the probable root cause/s could be the fluid ingression into the handpiece due to an internal leak due to a broken/damaged bond on the internal suction tubing.The failure mode will be monitored for future reoccurrence.
 
Event Description
It was reported that the device continuously activated.
 
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Brand Name
RF 2 PROBES, 90-S MAX
Type of Device
ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES
Manufacturer (Section D)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
Manufacturer (Section G)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
Manufacturer Contact
lucas wolski
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key16161589
MDR Text Key307677912
Report Number0002936485-2023-00022
Device Sequence Number1
Product Code GEI
UDI-Device Identifier07613327057027
UDI-Public07613327057027
Combination Product (y/n)N
Reporter Country CodeRO
PMA/PMN Number
K160050
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Company Representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 03/02/2023
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 Operator Other
Device Model Number0279401100
Device Catalogue Number0279401100
Device Lot Number22143AE2
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/13/2023
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 12/16/2022
Initial Date FDA Received01/13/2023
Supplement Dates Manufacturer Received12/16/2022
Supplement Dates FDA Received03/02/2023
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured05/13/2022
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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