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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE AGG. PLUS SHAVER BLADE SMALL JOINT F-SERIES 2.5MM EACH - ORDER MULTIPLES; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE AGG. PLUS SHAVER BLADE SMALL JOINT F-SERIES 2.5MM EACH - ORDER MULTIPLES; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Catalog Number 0375628000
Medical Device Problem Code Material Fragmentation (1261)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/17/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the device breaking during the procedure.All broken pieces were retrieved.
 
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Additional Manufacturer Narrative
It was confirmed that the device will not be returned.This complaint investigation was closed based on the device not received, therefore the reported failure mode was not confirmed.In the event that the device is received, the complaint will be reopened and the investigation will be updated with new results.Alleged failure: device breaking during procedure probable root cause: inadequate window profile.Inadequate welding process.Improper material strength.Inadequate size selected for the application.Material brittleness.Excessive force applied by the user.Incorrect rfid tag.The reported failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that the device breaking during the procedure.All broken pieces were retrieved.
 
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Brand Name
AGG. PLUS SHAVER BLADE SMALL JOINT F-SERIES 2.5MM EACH - ORDER MULTIPLES
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 Key21684159
Report Number0002936485-2025-00236
Device Sequence Number18336480
Product Code GFA
UDI-Device Identifier37613327061988
UDI-Public37613327061988
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source User Facility
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup
Report Date (Section B) 06/12/2025
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 Number0375628000
Device Lot Number23187CE2
Was Device Available for Evaluation? No
Date Returned to Manufacturer03/22/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 02/24/2025
Supplement Date Received by Manufacturer05/14/2025
Initial Report FDA Received Date03/24/2025
Supplement Report FDA Received Date06/12/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/06/2023
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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