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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER-ENDOSCOPY LAKELAND 5300; ARTHROSCOPE

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STRYKER-ENDOSCOPY LAKELAND 5300; ARTHROSCOPE Back to Search Results
Model Number 375-545-000
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/04/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was not returned to stryker sustainability solutions for evaluation.The customer reported the device was not saved.However, photographs of the device and package label were taken by the complainant and provided.Upon inspection of the received photograph of the complaint device, the inner "white plastic" shaft on the metal tip end with the teeth was completely detached.Revealed damage to the device.The photograph taken by the complainant indicated that the complaint device was confirmed for the reported failure mode.A review of the dhr supports that the device met all inspection and test criteria prior to release from stryker.Therefore, the most likely root cause could be attributed to mishandling, material degradation through use, or shipping and storage conditions, subsequent to distribution from stryker.The instructions for use (ifu) state: before beginning the procedure, verify compatibility of all instruments and accessories.Plug in and set up the generator according to the instructions in the manufacturers¿ manual.Select an arthroscopic shaver with size, blade, and function most appropriate for the procedure.Inspect the instrument for overall condition and physical integrity.Do not use the instrument if any damage is noted.Return the instrument and packaging to stryker sustainability solutions if it is not in acceptable condition for surgery.Follow a suitable surgery protocol.Careful handling of the instrument is necessary to avoid damage or breakage as a result of excessive force.Do not apply excessive pressure or ¿side-load¿ the blade during use.Side-loading does not improve the performance of the instrument, can dull the blade, and/or produce metal particulates.Do not allow the arthroscopic shaver to come into contact with staples, clips or any metal object to avoid damage to the blade and possible patient injury.The tip of the bur or cutter must be irrigated periodically (general recommendation: once a minute) to cool the blade and prevent excised tissues from accumulating.Do not run the instrument without appropriate suction for the duration of the process.The reported event will continue to be monitored through post-market surveillance.Should the device become available for return, the investigation will be reopened.
 
Event or Problem Description
It was reported the device broke off during the procedure and that the doctor was able to retrieve the part.There was no patient injury or medical intervention reported.The complainant is not aware of any extended procedure time.These are commonly used devices that are readily available.
 
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Brand Name
NA
Common Device Name
ARTHROSCOPE
Manufacturer (Section D)
STRYKER-ENDOSCOPY LAKELAND 5300
5300 region ct
lakeland FL 33815
Manufacturer (Section G)
STRYKER-ENDOSCOPY LAKELAND 5300
5300 region ct
lakeland FL 33815
Manufacturer Contact
andy dobos
1810 w. drake drive
tempe, AZ 85283
8888883433
MDR Report Key17035281
Report Number0001056128-2023-00016
Device Sequence Number6460088
Product Code HRX
UDI-Device Identifier00885825014223
UDI-Public00885825014223
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
K012635
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 05/31/2023
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 Expiration Date10/29/2023
Device Model Number375-545-000
Device Catalogue Number375-545-000RR
Device Lot Number12116073
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 05/04/2023
Initial Report FDA Received Date05/31/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured10/29/2020
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)
Yes
Usage of Device Reuse
Patient Sequence Number1
Patient SexMale
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