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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE UNKNOWN_ENDOSCOPY_PRODUCT; ARTHROSCOPE

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STRYKER ENDOSCOPY-SAN JOSE UNKNOWN_ENDOSCOPY_PRODUCT; ARTHROSCOPE Back to Search Results
Catalog Number UNK_END
Device Problems Material Integrity Problem (2978); Adverse Event Without Identified Device or Use Problem (2993)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 09/05/2019
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.Since the part number has not been provided, the gtin and 510k number are not available at this time.If the part number becomes available, it will be provided in future reports.
 
Event Description
It was reported that the device scuffed the hyaline cartilage.
 
Manufacturer Narrative
The reported device was not received for investigation; therefore the reported failure cannot be confirmed.The complaint will be closed without a detailed investigation.In the event that the device is received, the complaint will be reopened and the investigation will be updated with the new results.Probable root cause for the reported failure involving this device could not be determined due to insufficient information.In sum, the reported failure could not be confirmed since the device was not received at stryker endoscopy for investigation.Manufacture date is not known.Gtin:unk.
 
Event Description
It was reported that the device scuffed the hyaline cartilage.
 
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Brand Name
UNKNOWN_ENDOSCOPY_PRODUCT
Type of Device
ARTHROSCOPE
Manufacturer (Section D)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
MDR Report Key9147812
MDR Text Key166055251
Report Number0002936485-2019-00442
Device Sequence Number1
Product Code HRX
Combination Product (y/n)N
PMA/PMN Number
UNKNOWN
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type health professional
Type of Report Initial,Followup
Report Date 12/17/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received10/02/2019
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberUNK_END
Was Device Available for Evaluation? No
Date Manufacturer Received09/05/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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