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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE RF 2 PROBE, MICRO-BRUSH; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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STRYKER ENDOSCOPY-SAN JOSE RF 2 PROBE, MICRO-BRUSH; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Catalog Number 0279250201
Medical Device Problem Code Continuous Firing (1123)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/15/2024
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 the device continuously activated.
 
Additional Manufacturer Narrative
Alleged failure: the rf probe continued to output even after hand was removed from the switch.The failure(s) identified in the investigation is consistent with the complaint record.The probable root cause/s could be a probe short due to a fluid ingress.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that the device continuously activated.
 
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Brand Name
RF 2 PROBE, MICRO-BRUSH
Common Device Name
ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES
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
chester rebugio
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key19097112
Report Number0002936485-2024-00324
Device Sequence Number15289688
Product Code GEI
UDI-Device Identifier07613327056860
UDI-Public07613327056860
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K160050
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Distributor
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 07/08/2024
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 Number0279250201
Device Lot Number23345AE2
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 03/18/2024
Supplement Date Received by Manufacturer03/18/2024
Initial Report FDA Received Date04/12/2024
Supplement Report FDA Received Date07/08/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/11/2023
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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