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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG CONNECTED OR HUB BASE SYSTEM; LAPAROSCOPE, GENERAL & PLASTIC SURGERY

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STRYKER ENDOSCOPY-SAN JOSE PKG CONNECTED OR HUB BASE SYSTEM; LAPAROSCOPE, GENERAL & PLASTIC SURGERY Back to Search Results
Catalog Number 0240200200
Medical Device Problem Codes No Display/Image (1183); Connection Problem (2900)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/04/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.The device manufacturer date is not known at this time.However, should it become available it will be provided in future reports.
 
Event or Problem Description
It was reported that there was loss of image.
 
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: loss of image.Probable root cause: ¿ cables, connectors, sources, or sinks ¿ capture card, motherboard, power supply ¿ sdc firmware ¿ over-heating ¿ sdc application software [cor, ip], clarity package ¿ clarity algorithm ¿ use error ¿ cybersecurity the reported failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that there was no image to the system from the camera, had to wire directly to a display.Therefore, there was a loss of image.
 
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Brand Name
PKG CONNECTED OR HUB BASE SYSTEM
Common Device Name
LAPAROSCOPE, GENERAL & PLASTIC SURGERY
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 Key21712419
Report Number0002936485-2025-00248
Device Sequence Number14587504
Product Code GCJ
UDI-Device Identifier07613327601695
UDI-Public07613327601695
Combination Product (Y/N)N
Initial Reporter StateCO
Initial Reporter CountryUS
PMA/510(K) Number
K222079
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 09/05/2025
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 Number0240200200
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 03/04/2025
Supplement Date Received by Manufacturer08/13/2025
Initial Report FDA Received Date03/27/2025
Supplement Report FDA Received Date09/05/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Is the Device Labeled for Single Use? (Y/N) No
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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