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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG., TOMCAT SHAVER BLADE, F - SERIES - 4.0MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE PKG., TOMCAT SHAVER BLADE, F - SERIES - 4.0MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Catalog Number 0375545000
Medical Device Problem Code Device Contaminated During Manufacture or Shipping (2969)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/26/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that there was foreign material in the sterile packaging.
 
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Additional Manufacturer Narrative
Alleged failure: on opening the blister pack, the operator noticed a hair wrapped around the burr.The failure(s) identified in the investigation is consistent with the complaint record.The probable root cause/s could be improper cleaning process, qc incoming, and in-process inspections.The material was not removed during the cleaning process.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that there was foreign material in the sterile packaging.
 
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Brand Name
PKG., TOMCAT SHAVER BLADE, F - SERIES - 4.0MM
Common Device Name
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 Key20055545
Report Number0002936485-2024-00596
Device Sequence Number18172162
Product Code GFA
UDI-Device Identifier37613327061797
UDI-Public37613327061797
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
EXEMPT
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) 11/11/2024
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 Other
Device Catalogue Number0375545000
Device Lot Number24033CE2
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 07/30/2024
Supplement Date Received by Manufacturer07/30/2024
Initial Report FDA Received Date08/23/2024
Supplement Report FDA Received Date11/11/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/02/2024
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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