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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE NANOPASS REACH CRESCENT; PASSER

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STRYKER ENDOSCOPY-SAN JOSE NANOPASS REACH CRESCENT; PASSER Back to Search Results
Catalog Number CAT02298
Medical Device Problem Code Material Fragmentation (1261)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/10/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the nanopass crescent sheath broke in patient.The doctor had to fish out broken metal in patient.It was replaced with a new disposable device.
 
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 the nanopass crescent sheath broke in patient.The doctor had to fish out broken metal in patient.It was replaced with a new disposable device.
 
Additional Manufacturer Narrative
Multiple attempts have been made to retrieve the device for evaluation, and it is yet to be received 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: passer broke probable root cause: application, - user technique related factors, - difficult anatomy, extremely tough soft tissue.The reported failure mode will be monitored for future reoccurrence.
 
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Brand Name
NANOPASS REACH CRESCENT
Common Device Name
PASSER
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 Key22745208
Report Number0002936485-2025-00685
Device Sequence Number18269417
Product Code HWQ
UDI-Device Identifier07613252633204
UDI-Public07613252633204
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
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) 11/04/2025
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 NumberCAT02298
Device Lot Number012066
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 07/10/2025
Supplement Date Received by Manufacturer10/29/2025
Initial Report FDA Received Date08/07/2025
Supplement Report FDA Received Date11/04/2025
Was Device Evaluated by Manufacturer? (Y/N) No
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 Age36 YR
Patient SexFemale
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