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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP BIPOLAR GENERATOR; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP BIPOLAR GENERATOR; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Model Number 6700-343-500
Medical Device Problem Code Output below Specifications (3004)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/01/2023
Type of Reportable Event Malfunction
Event or Problem Description
The user facility reported the device was underdelivering energy during a procedure, a condition which may pose the risk of insufficient coagulation and increased bleeding.The procedure was completed successfully.There was no clinically significant delay, no medical intervention, and no adverse consequences.
 
Event or Problem Description
The user facility reported the device was underdelivering energy during a procedure, a condition which may pose the risk of insufficient coagulation and increased bleeding.The procedure was completed successfully.There was no clinically significant delay, no medical intervention, and no adverse consequences.
 
Additional Manufacturer Narrative
Follow-up report submitted to document device evaluation results.
 
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Brand Name
BIPOLAR GENERATOR
Common Device Name
ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES
Manufacturer (Section D)
STRYKER INSTRUMENTS-A DIVISION OF STRYKER CORP
1941 stryker way
portage MI 49002
Manufacturer (Section G)
STRYKER INSTRUMENTS-KALAMAZOO
4100 east milham avenue
kalamazoo MI 49001
Manufacturer Contact
colette chung
1941 stryker way
portage, MI 49002
2693237700
MDR Report Key17013827
Report Number3015967359-2023-01201
Device Sequence Number7637114
Product Code GEI
UDI-Device Identifier07613327303889
UDI-Public07613327303889
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K050364
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 09/21/2023
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 Number6700-343-500
Device Catalogue Number6700313500
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 05/01/2023
Supplement Date Received by Manufacturer09/11/2023
Initial Report FDA Received Date05/26/2023
Supplement Report FDA Received Date09/21/2023
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/19/2022
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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