MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG SAFELIGHT HENKE DYONICS STORZ SCOPE ADAPTER; LAPAROSCOPE, GENERAL & PLASTIC SURGERY

Catalog Number	0233050087
Medical Device Problem Codes	Optical Problem (3001); Output Problem (3005)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	05/14/2025
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported by the customer that "during dissection on a laparoscopic hysterectomy, the stryker tower announced "light source deactivated".It then continued to strobe between on and off, alternating saying "light source activated and light source deactivated".Gyne charge nurse was quickly retrieved for the situation.A new tower and camera and laparoscope were quickly acquired, but after hooking them up, the same problem occurred.The team then tried a new light cord, and this fixed the problem.The light cord was isolated in a ziploc bag with a note to return it to the cnl upon cleaning".Therefore, there was loss of light.
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
Event or Problem Description
It was reported by the customer that "during dissection on a laparoscopic hysterectomy, the stryker tower announced "light source deactivated".It then continued to strobe between on and off, alternating saying "light source activated and light source deactivated".Gyne charge nurse was quickly retrieved for the situation.A new tower and camera and laparoscope were quickly acquired, but after hooking them up, the same problem occurred.The team then tried a new light cord, and this fixed the problem.The light cord was isolated in a ziploc bag with a note to return it to the cnl upon cleaning".Therefore, there was loss of light.
Additional Manufacturer Narrative
Alleged failure: it was reported by the customer that "during dissection on a laparoscopic hysterectomy, the stryker tower announced "light source deactivated".It then continued to strobe between on and off, alternating saying "light source activated and light source deactivated".Gyne charge nurse was quickly retrieved for the situation.A new tower and camera and laparoscope were quickly acquired, but after hooking them up, the same problem occurred.The team then tried a new light cord, and this fixed the problem.The light cord was isolated in a ziploc bag with a note to return it to the cnl upon cleaning".The failure alleged in the complaint record was not confirmed/duplicated during the product investigation.Probable root causes are: resistance values out of range likely due to a reed switch issue.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.

• Brand Name: PKG SAFELIGHT HENKE DYONICS STORZ SCOPE ADAPTER
• 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 Key: 22331966
• Report Number: 0002936485-2025-00579
• Device Sequence Number: 8410628
• Product Code: GCJ
• UDI-Device Identifier: 07613327161618
• UDI-Public: 07613327161618
• Combination Product (Y/N): N
• Initial Reporter Country: CA
• PMA/510(K) Number: K082813
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: User Facility
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 08/29/2025

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 Number: 0233050087
• Device Lot Number: 23E5318
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Initial
• Initial Date Received by Manufacturer: 05/30/2025
• Supplement Date Received by Manufacturer: 08/06/2025
• Initial Report FDA Received Date: 06/25/2025
• Supplement Report FDA Received Date: 08/29/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 05/01/2023
• 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 Number: 1
• Patient Sex: Unknown