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	10/30/2024
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The device was returned to stryker sustainability solutions for evaluation.Upon inspection of the received complaint device, evidence of bio-burden was observed on the device.The teflon pad, jaw, buttons, handle, cable, and contact pins appear to be intact.The complaint device was received with a broken blade tip.Functional testing was performed using a g11 scalpel generator, using the appropriate harhpgr hand piece.The device presented with a 'no instrument uses remaining' error as expected due to previous clinical use.The returned complaint device was reset/unlocked using a rigol dp832 programmable dc power supply and labview 2023 vi package manager.The returned complaint device was successfully reset.The data is captured and retained at stryker's sustainability solutions business unit.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 low energy button an additional error was populated on the g11 screen, 'replace instrument'.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: - shipping/handling damage post distribution from stryker's sustainability solutions - 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 - cleaning instrument or blade tip with abrasives 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.
Event or Problem Description
It was reported that the har1136 instructed to remove form patient during use, clean blade, then prompted to replace device.There was no patient injury, medical intervention, or extended procedure time reported.These are commonly used devices that are readily available.
Event or Problem Description
It was reported that the har1136 instructed to remove form patient during use, clean blade, then prompted to replace device.Per the sales representative, the complaint device did not have a broken blade present.There was no patient injury, medical intervention, or extended procedure time reported.These are commonly used devices that are readily available.
Additional Manufacturer Narrative
Additional information: per the sales representative, the complaint device did not have a broken blade present.

• 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: 21095979
• Report Number: 0001056128-2025-00003
• Device Sequence Number: 12995566
• 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,Followup
• Report Date (Section B): 02/07/2025

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 Model Number: HAR1136
• Device Catalogue Number: HAR1136
• Device Lot Number: 16216838
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 11/12/2024
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Follow-Up
• Initial Date Received by Manufacturer: 12/10/2024
• Supplement Date Received by Manufacturer: 01/13/2025
• Initial Report FDA Received Date: 01/07/2025
• Supplement Report FDA Received Date: 02/07/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 09/09/2024
• 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