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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG. SINGLE SPIKE TUBE SET; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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STRYKER ENDOSCOPY-SAN JOSE PKG. SINGLE SPIKE TUBE SET; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Catalog Number 0250070530
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 02/19/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that foreign material was found inside the sterile packaging.
 
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Event or Problem Description
It was reported that after opening pn: 250-070-530, the staff noticed what looks like a piece of glove in the packaging.The product did make it to the sterile field but it was removed prior to any use.No major delays incurred.Therefore, was foreign material was found inside the sterile packaging.
 
Additional Manufacturer Narrative
Alleged failure: need to report an incident with suction/irrigation at (b)(6) medical center this morning.After opening pn: 250-070-530, staff noticed what looks like a piece of glove in the packaging.The product did make it to the sterile field but it was removed prior to any use.No major delays incurred.The failure(s) identified in the investigation is consistent with the complaint record.The probable root causes could be contaminants fell in during packaging.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
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Brand Name
PKG. SINGLE SPIKE TUBE SET
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
andy dobos
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key21642203
Report Number0002936485-2025-00220
Device Sequence Number7614292
Product Code GEI
UDI-Device Identifier37613327061353
UDI-Public37613327061353
Combination Product (Y/N)N
Initial Reporter StateVA
Initial Reporter CountryUS
PMA/510(K) Number
K963646
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) 08/22/2025
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 Number0250070530
Device Lot Number24297FG2
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 02/19/2025
Supplement Date Received by Manufacturer07/30/2025
Initial Report FDA Received Date03/19/2025
Supplement Report FDA Received Date08/22/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/23/2024
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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