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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE UNKNOWN_ENDOSCOPY_PRODUCT; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE UNKNOWN_ENDOSCOPY_PRODUCT; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Model Number 0375704500
Medical Device Problem Codes Continuous Firing (1123); Failure to Shut Off (2939)
Health Effect - Clinical Codes Insufficient Information (4580); No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/24/2022
Type of Reportable Event Malfunction
Additional 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 or Problem Description
It was reported that the device was continuously activating.
 
Additional Manufacturer Narrative
The product was not returned for investigation and the reported failure mode was not confirmed.Alleged failure: shaver does not stop milling.Probable root cause: breaking resistors on the flex circuitry due to stress on flex cable (due to manufacturing and assembly error combined with normal use stress).Broken handpiece cable, or conductors inside.No power from the console.Broken traces on the membrane switch.Membrane switch is corroded due to moisture ingress.Flattened buttons/ switches.Poor soldering or other electrical connection.Broken pin.Pcba component failure.Button press reaction force so high the buttons can't be pressed to deliver information.Console not delivering power to shaver (refer to rsk10642, rsk10686).Expired disposable after r.1.1.1.Use error.The device manufacture date is not known.The reported failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that the device was continuously activating.
 
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Brand Name
UNKNOWN_ENDOSCOPY_PRODUCT
Common Device Name
BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL
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
andrea zenere
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key13546308
Report Number0002936485-2022-00088
Device Sequence Number20264092
Product Code GFA
UDI-Device Identifier07613327057638
UDI-Public07613327057638
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 Other
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 04/20/2022
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 Model Number0375704500
Device Catalogue NumberUNK_END
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/24/2022
Supplement Date Received by Manufacturer01/24/2022
Initial Report FDA Received Date02/16/2022
Supplement Report FDA Received Date04/20/2022
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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