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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE AGG. PLUS SHAVER BLADE F-SERIES 4.0MM EACH - ORDER MULTIPLES OF 5; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE AGG. PLUS SHAVER BLADE F-SERIES 4.0MM EACH - ORDER MULTIPLES OF 5; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Catalog Number 0375544000
Medical Device Problem Code Material Fragmentation (1261)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/21/2024
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the device broke during the procedure.All broken pieces were retrieved with use of x-ray.
 
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Additional Manufacturer Narrative
Alleged failure: during scopic knee surgery, part of the stryker shaver broke off the failure(s) identified in the investigation is consistent with the complaint record.The probable root cause could be excessive force applied by the user such as (bending or prying, which may cause the arthroscopic shaver blades to bend or break).The blade came in contact with a hard object, causing damaging the teeth, and hitting the housing edges.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 broke during the procedure.All broken pieces were retrieved with use of x-ray.
 
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Brand Name
AGG. PLUS SHAVER BLADE F-SERIES 4.0MM EACH - ORDER MULTIPLES OF 5
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 Key20695085
Report Number0002936485-2024-00798
Device Sequence Number3714439
Product Code GFA
UDI-Device Identifier37613327061780
UDI-Public37613327061780
Combination Product (Y/N)N
Initial Reporter CountryDA
PMA/510(K) Number
EXEMPT
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) 02/26/2025
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 Number0375544000
Device Lot Number24131CE2
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/11/2024
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 10/21/2024
Supplement Date Received by Manufacturer10/21/2024
Initial Report FDA Received Date11/15/2024
Supplement Report FDA Received Date02/26/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/10/2024
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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