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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE FORMULA 180 SHAVER INTERNATIONAL KIT.; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE FORMULA 180 SHAVER INTERNATIONAL KIT.; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Model Number 0375708500
Device Problem Continuous Firing (1123)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 10/28/2022
Event Type  malfunction  
Event Description
It was reported that the device was continuously activating.
 
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.
 
Manufacturer Narrative
The device was received at the local service facility for investigation.The technical service report is attached(see communication log), and indicates: service code: a the repair includes: defective parts replacement, leakage current function test calvier rplcmt joint, membrane, revision.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 reported failure mode will be monitored for future reoccurrence.
 
Event Description
It was reported that the device was continuously activating.
 
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Brand Name
FORMULA 180 SHAVER INTERNATIONAL KIT.
Type of Device
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
lucas wolski
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key15848536
MDR Text Key304368619
Report Number0002936485-2022-00698
Device Sequence Number1
Product Code GFA
UDI-Device Identifier07613327057645
UDI-Public07613327057645
Combination Product (y/n)N
Reporter Country CodeFR
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Company Representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 01/21/2023
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received11/22/2022
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Model Number0375708500
Device Catalogue Number0375708500E
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Date Manufacturer Received10/28/2022
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured02/01/2022
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
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