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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG L10 LED LIGHT SOURCE WITH AIM; CONFOCAL OPTICAL IMAGING

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STRYKER ENDOSCOPY-SAN JOSE PKG L10 LED LIGHT SOURCE WITH AIM; CONFOCAL OPTICAL IMAGING Back to Search Results
Catalog Number 0220220300
Medical Device Problem Codes Display or Visual Feedback Problem (1184); Overheating of Device (1437); Device Sensing Problem (2917)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/19/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Event or Problem Description
It was reported that light source that would not immediately turn off when pressing the console touch screen.Therefore, there was a thermal event.
 
Additional Manufacturer Narrative
Alleged failure: light source that would not immediately turn off when pressing the console touch screen.The failure(s) identified in the investigation is consistent with the complaint record.The probable root cause could be a component issue with the main board causing the lightsource to freeze and not respond to touch while activated.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that light source that would not immediately turn off when pressing the console touch screen.Therefore, there was a thermal event.
 
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Brand Name
PKG L10 LED LIGHT SOURCE WITH AIM
Common Device Name
CONFOCAL OPTICAL IMAGING
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 Key22524450
Report Number0002936485-2025-00643
Device Sequence Number8058565
Product Code OWN
UDI-Device Identifier07613327051377
UDI-Public07613327051377
Combination Product (Y/N)N
Initial Reporter StateDE
Initial Reporter CountryUS
PMA/510(K) Number
K142310
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) 09/17/2025
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 Number0220220300
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 06/19/2025
Supplement Date Received by Manufacturer08/19/2025
Initial Report FDA Received Date07/16/2025
Supplement Report FDA Received Date09/17/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/01/2016
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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