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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG STRYKERFLOW ELECTROCAUTERY PROBE L TIP 5MM; LAPAROSCOPE, GENERAL & PLASTIC SURGERY

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STRYKER ENDOSCOPY-SAN JOSE PKG STRYKERFLOW ELECTROCAUTERY PROBE L TIP 5MM; LAPAROSCOPE, GENERAL & PLASTIC SURGERY Back to Search Results
Catalog Number 0250070443
Medical Device Problem Code Sparking (2595)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 03/25/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.The device manufacturer date and pma/510(k) information 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 the device sparked.
 
Additional Manufacturer Narrative
The device is not available for evaluation in-house.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: sparking probable root cause: wrong instrument, generator settings, insulation damage, use error.The reported failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that the device sparked.
 
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Brand Name
PKG STRYKERFLOW ELECTROCAUTERY PROBE L TIP 5MM
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 Key21890716
Report Number0002936485-2025-00377
Device Sequence Number8053077
Product Code GCJ
UDI-Device Identifier07613327051872
UDI-Public07613327051872
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K934094
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) 09/12/2025
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 Number0250070443
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 03/27/2025
Supplement Date Received by Manufacturer08/18/2025
Initial Report FDA Received Date04/23/2025
Supplement Report FDA Received Date09/12/2025
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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