MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE CROSSFIRE CONSOLE INTERNATIONAL KIT; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

Model Number 0475000000

Device Problem Activation Failure (3270)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Date 04/10/2023

Event Type  malfunction  

Manufacturer Narrative

Additional information will be provided once the investigation has been completed.The device manufacturer date is not known at this time.However, should it become available it will be provided in future reports.

Event Description

It was reported that the procedure was cancelled.The patient was under anesthesia, but no incision was made.

Manufacturer Narrative

This complaint investigation was closed based on the device not received, therefore the reported failure mode was not confirmed.In the event that the device is received, the complaint will be reopened and the investigation will be updated with new results.Alleged failure: device did not boot up.Probable root cause: software error.Front board issue.Blown fuse.Power board issue.Electromagnetic interference (emi) from rf communication, hf surgical instruments, esd, or power surge.Insufficient cybersecurity (cf).The reported failure mode will be monitored for future reoccurrence.Manufacture date is not known.H3 other text : 81.

Event Description

It was reported that the procedure was cancelled.The patient was under anesthesia, but no incision was made.

• Brand Name: CROSSFIRE CONSOLE INTERNATIONAL KIT
• 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 Key: 16898803
• MDR Text Key: 314887194
• Report Number: 0002936485-2023-00405
• Device Sequence Number: 1
• Product Code: GEI
• UDI-Device Identifier: 07613327058086
• UDI-Public: 07613327058086
• Combination Product (y/n): N
• Reporter Country Code: JA
• PMA/PMN Number: K071859
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Distributor
• Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date: 03/15/2024

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
• Device Operator: Health Professional
• Device Model Number: 0475000000
• Device Catalogue Number: 0475000000I
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: No
• Initial Date Manufacturer Received: 04/10/2023
• Initial Date FDA Received: 05/09/2023
• Supplement Dates Manufacturer Received: 04/10/2023
• Supplement Dates FDA Received: 03/15/2024
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: No
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Reuse
• Patient Sequence Number: 1