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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG., RESECTOR SHAVER BLADE, F - SERIES - 4.0MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE PKG., RESECTOR SHAVER BLADE, F - SERIES - 4.0MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Catalog Number 0375542000
Medical Device Problem Code Packaging Problem (3007)
Health Effect - Clinical Codes Insufficient Information (4580); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/07/2020
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Event or Problem Description
It was reported that there was foreign material in the sterile packaging.
 
Additional Manufacturer Narrative
Alleged failure: a red stripe was discovered at the distal end of the shaver blade the failure alleged in the complaint record was not confirmed during the product investigation.Based on the alleged claim the probable root cause/s could be a small amount of plastic (flash) was created during the inductive process or an insertion of the inner cutter accidentally scraped the housing hub and remained attached to the cutter teeth.The improper cleaning process, qc incoming, and in-process inspections.An nc was opened to address the issue.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that there was foreign material in the sterile packaging.
 
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Brand Name
PKG., RESECTOR SHAVER BLADE, F - SERIES - 4.0MM
Common Device Name
BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL
Manufacturer (Section D)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
MDR Report Key11032395
Report Number0002936485-2020-00542
Device Sequence Number1307902
Product Code GFA
UDI-Device Identifier37613327061810
UDI-Public37613327061810
Combination Product (Y/N)N
Initial Reporter CountrySZ
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source health professional
Initial Reporter Occupation Nurse
Type of Report Initial,Followup
Report Date (Section B) 03/01/2021
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 Health Professional
Device Catalogue Number0375542000
Device Lot Number20210CE2
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/12/2020
Initial Date Received by Manufacturer 12/07/2020
Supplement Date Received by Manufacturer12/07/2020
Initial Report FDA Received Date12/17/2020
Supplement Report FDA Received Date03/01/2021
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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