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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE RF 2 PROBES MICRO-CLAW; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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STRYKER ENDOSCOPY-SAN JOSE RF 2 PROBES MICRO-CLAW; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Catalog Number 0279250101
Medical Device Problem Code Material Fragmentation (1261)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/09/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that parts of the tip broke off during procedure.All of the broken pieces were retrieved from patient.
 
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Event or Problem Description
It was reported that parts of the tip broke off during procedure.All of the broken pieces were retrieved from patient.
 
Additional Manufacturer Narrative
It was reported that the device will not be returned for investigation.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: tip broken probable root cause: non-conforming component, poor assembly process, misuse.Use errors probe used as a tool for mechanical displacement of tissue or bone, or to pry or scrub excessive force used when inserting of removing probe, probe inserted into obstructed passageway, or any forceful impact to the tip of the probe with rigid objects excessive use of device beyond stated lifetime the reported failure mode will be monitored for future reoccurrence.
 
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Brand Name
RF 2 PROBES MICRO-CLAW
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 Key22332172
Report Number0002936485-2025-00584
Device Sequence Number8560533
Product Code GEI
UDI-Device Identifier07613327056877
UDI-Public07613327056877
Combination Product (Y/N)N
Initial Reporter StateWI
Initial Reporter CountryUS
PMA/510(K) Number
K160050
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Nurse
Type of Report Initial,Followup
Report Date (Section B) 09/18/2025
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 Number0279250101
Device Lot Number24311AE2
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 05/29/2025
Supplement Date Received by Manufacturer08/26/2025
Initial Report FDA Received Date06/25/2025
Supplement Report FDA Received Date09/18/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/06/2024
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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