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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE SERFAS 50-S SWEEP +; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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STRYKER ENDOSCOPY-SAN JOSE SERFAS 50-S SWEEP +; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Catalog Number 0279351650
Medical Device Problem Code Failure to Deliver Energy (1211)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/24/2024
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 had insufficient / no energy delivered.
 
Additional Manufacturer Narrative
Alleged failure: serfas probe did not react.The failure(s) identified in the investigation is consistent with the complaint record.The probable causes of the issue may include poor contact with the probe's buttons (possibly due to a dirty electrical connection) or a communication error between the probe and the console.There could also be a short or open circuit in the pcb switches.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 had insufficient / no energy delivered.
 
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Brand Name
SERFAS 50-S SWEEP +
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
lucas wolski
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key21183727
Report Number0002936485-2025-00048
Device Sequence Number8537192
Product Code GEI
UDI-Device Identifier07613327405811
UDI-Public07613327405811
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K171391
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 07/14/2025
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 Number0279351650
Device Lot Number24135AE2
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 12/25/2024
Supplement Date Received by Manufacturer06/16/2025
Initial Report FDA Received Date01/17/2025
Supplement Report FDA Received Date07/14/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/14/2024
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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