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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG., AGG. PLUS SHAVER BLADE, SMALL JOINT, F - SERIES - 2.5MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE PKG., AGG. PLUS SHAVER BLADE, SMALL JOINT, F - SERIES - 2.5MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Catalog Number 0375628000
Medical Device Problem Code Contamination /Decontamination Problem (2895)
Health Effect - Clinical Codes Insufficient Information (4580); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/22/2021
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 foreign object was spotted inside the packaging of the sterile shaverblade.The failure(s) identified in the investigation is consistent with the complaint record.The probable root cause/s could be an improper cleaning process, qc incoming, and in-process inspection.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., AGG. PLUS SHAVER BLADE, SMALL JOINT, F - SERIES - 2.5MM
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 Key12344452
Report Number0002936485-2021-00443
Device Sequence Number3601750
Product Code GFA
UDI-Device Identifier37613327061988
UDI-Public37613327061988
Combination Product (Y/N)N
Initial Reporter CountryGM
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) 10/20/2021
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 Number0375628000
Device Lot Number19336CE2
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/16/2021
Initial Date Received by Manufacturer 07/25/2021
Supplement Date Received by Manufacturer07/25/2021
Initial Report FDA Received Date08/19/2021
Supplement Report FDA Received Date10/20/2021
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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