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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-KALAMAZOO ROCKER-SWITCH SMOKE EVAC PENCIL, COATED; ELECTROSURGICAL CUTTING AND COAGULATION DEVICE AND ACCESSORIES

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STRYKER INSTRUMENTS-KALAMAZOO ROCKER-SWITCH SMOKE EVAC PENCIL, COATED; ELECTROSURGICAL CUTTING AND COAGULATION DEVICE AND ACCESSORIES Back to Search Results
Catalog Number 0703047000
Device Problem Device Remains Activated (1525)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 04/19/2023
Event Type  malfunction  
Event Description
It was reported that during a procedure the e-sep pencil was stuck in "coag" mode and would not go off.The procedure was completed successfully without a delay; no adverse consequences or medical intervention were reported.This is event 6 of 8.
 
Manufacturer Narrative
A follow up report will be filed once the quality investigation is complete.Awaiting confirmation if device is available.
 
Event Description
It was reported that during a procedure the e-sep pencil was stuck in "coag" mode and would not go off.The procedure was completed successfully without a delay; no adverse consequences or medical intervention were reported.This is event 6 of 8.
 
Manufacturer Narrative
H6: the quality investigation is complete.
 
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Brand Name
ROCKER-SWITCH SMOKE EVAC PENCIL, COATED
Type of Device
ELECTROSURGICAL CUTTING AND COAGULATION DEVICE AND ACCESSORIES
Manufacturer (Section D)
STRYKER INSTRUMENTS-KALAMAZOO
4100 east milham avenue
kalamazoo MI 49001
Manufacturer (Section G)
STRYKER INSTRUMENTS-IRELAND
instruments division
carrigtwohill bus. & tech park
carrigtwohill NA
EI   NA
Manufacturer Contact
colette chung
instruments division
carrigtwohill bus. & tech park
carrigtwohill NA
EI   NA
214532900
MDR Report Key16946241
MDR Text Key315535206
Report Number0001811755-2023-00086
Device Sequence Number1
Product Code GEI
UDI-Device Identifier37613327117203
UDI-Public37613327117203
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
K143145
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type User Facility
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 03/12/2024
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 Catalogue Number0703047000
Device Lot Number66133414
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Initial Date Manufacturer Received 04/19/2023
Initial Date FDA Received05/17/2023
Supplement Dates Manufacturer Received02/20/2024
Supplement Dates FDA Received03/12/2024
Was Device Evaluated by Manufacturer? No
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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