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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE 2.0MM XBRAID TT, 100% UHMWPE, VIOLET CO-BRAID; SUTURE, NONABSORBABLE, SYNTHETIC, POLYETHYLENE

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STRYKER ENDOSCOPY-SAN JOSE 2.0MM XBRAID TT, 100% UHMWPE, VIOLET CO-BRAID; SUTURE, NONABSORBABLE, SYNTHETIC, POLYETHYLENE Back to Search Results
Catalog Number 3910-900-018
Medical Device Problem Code Expiration Date Error (2528)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/25/2023
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 an expired product was used.
 
Additional Manufacturer Narrative
This complaint investigation was closed based on the device not received, therefore the reported failure mode was not confirmed.In the event that the device is received, the complaint will be reopened and the investigation will be updated with new results.Alleged failure: expired product implanted.Probable root cause: design: insufficient labeling design.Insufficient shelf life validated.Application: failure to verify expiration status of product prior to surgery.The reported failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that an expired product was used.
 
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Brand Name
2.0MM XBRAID TT, 100% UHMWPE, VIOLET CO-BRAID
Common Device Name
SUTURE, NONABSORBABLE, SYNTHETIC, POLYETHYLENE
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 Key16977072
Report Number0002936485-2023-00492
Device Sequence Number17804490
Product Code GAT
UDI-Device Identifier37613327261517
UDI-Public37613327261517
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K162310
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Pharmacist
Type of Report Initial,Followup
Report Date (Section B) 03/15/2024
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 Number3910-900-018
Device Lot Number21099AE2
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 04/25/2023
Supplement Date Received by Manufacturer04/25/2023
Initial Report FDA Received Date05/22/2023
Supplement Report FDA Received Date03/15/2024
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured04/09/2021
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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