MAUDE Adverse Event Report: STRYKER-ENDOSCOPY LAKELAND 5300; SINGLE-USE REPROCESSED ULTRASONIC SURGICAL INSTRUMENTS

Model Number	HAR1136
Medical Device Problem Code	Fracture (1260)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	08/25/2024
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that the device failed after minimal use and only a couple of cuts were done before the device prompted to be cleaned.The device was cleaned and prompted to replace.Upon investigation of the complaint device, the blade tip fell off of the complaint device during disassembly.There was no patient injury, medical intervention, or extended procedure time reported.These are commonly used devices that are readily available.
Additional Manufacturer Narrative
The device was returned to stryker sustainability solutions for evaluation.Upon inspection of the received complaint device, the blade, teflon pad, jaw, buttons, handle, cable, and contact pins appear to be intact.After the device was successfully reset, the device was activated successfully using the same g11 scalpel generator, using the appropriate harhpgr hand piece.Upon pressing the energy button an audible whistling noise was heard coming from the device along with a screen error, "replace instrument".The returned complaint device was then disassembled to investigate further.Upon disassembly of the complaint device the blade tip fell off.The blade was inspected further and no anomalies were found.The shaft pin appeared straight and intact.A review of the dhr supports that the device met all inspection and test criteria prior to release from stryker.The reported event could be attributed to: too much force or torque applied to instrument, or grasping/pulling.Incidental and prolonged activation against solid surfaces, such as bone or plastic.Attempting to bend, sharpen, or otherwise alter the shape of the blade.The instructions for use (ifu) state: verify compatibility with generators.Use device only with ethicon endo-surgery generator g11 (gen11) software version 2018-1 or later.Software revision can be found under ¿system information¿ in the generator g11 (gen11) ¿settings¿ menu.Refer to the generator g11 (gen11) operator¿s manual for more information.Avoid contact with any and all metal or plastic instruments or objects when the instrument is activated.Contact with staples, clips or other instruments while the instrument is activated may result in scratches on the blade, cracked or broken blades and premature blade failure.Audible high-pitched ringing, resonating from the blade, is an abnormal condition and an indicator that the blade is not operating properly.This may result in abnormally high shaft temperatures and user or patient injury.Do not attempt to bend, sharpen, or otherwise alter the shape of the blade.Doing so may cause blade failure and user or patient injury.Care should be taken not to apply pressure between the instrument blade and tissue pad without having tissue between them.Clamping the tissue pad against the active blade without tissue on the full length of the blade will result in higher blade, clamp arm and distal shaft temperatures and can result in possible damage to the instrument.If this occurs, there may be an instrument failure, and the generator touchscreen displays a troubleshooting message.The reported event will continue to be monitored through post-market surveillance.

• Brand Name: NA
• Common Device Name: SINGLE-USE REPROCESSED ULTRASONIC SURGICAL INSTRUMENTS
• 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 Key: 20728796
• Report Number: 0001056128-2024-00097
• Device Sequence Number: 8922762
• Product Code: NLQ
• UDI-Device Identifier: 07613327586589
• UDI-Public: 07613327586589
• Combination Product (Y/N): N
• Initial Reporter State: OR
• Initial Reporter Country: US
• PMA/510(K) Number: K233471
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Initial Reporter Occupation: Other Health Care Professional
• Type of Report: Initial
• Report Date (Section B): 11/19/2024

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 Model Number: HAR1136
• Device Catalogue Number: HAR1136
• Device Lot Number: 15863844
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 10/14/2024
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 10/25/2024
• Initial Report FDA Received Date: 11/19/2024
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 05/06/2024
• 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): Yes
• Usage of Device: Reuse
• Patient Sequence Number: 1
• Patient Sex: Unknown