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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE FLOWPORT II CANNULA WITH OBTURATOR; ACCESSORIES, ARTHROSCOPIC

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STRYKER ENDOSCOPY-SAN JOSE FLOWPORT II CANNULA WITH OBTURATOR; ACCESSORIES, ARTHROSCOPIC Back to Search Results
Catalog Number CAT00776
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/28/2025
Type of Reportable Event Malfunction
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 plastic tip of cannula broke into the patient.This was retrieved by the surgeon however this procedure was prolonged by 15 minutes.
 
Additional Manufacturer Narrative
It was reported that the device was discarded by the customer.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 breaking probable root cause: application - excessive force - poor visualization through arthroscope the reported failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that the plastic tip of cannula broke into the patient.This was retrieved by the surgeon however this procedure was prolonged by 15 minutes.
 
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Brand Name
FLOWPORT II CANNULA WITH OBTURATOR
Common Device Name
ACCESSORIES, ARTHROSCOPIC
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
arsalan rizvi
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key23175671
Report Number0002936485-2025-00808
Device Sequence Number18363542
Product Code NBH
UDI-Device Identifier07613252632887
UDI-Public07613252632887
Combination Product (Y/N)N
Initial Reporter CountryUK
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Consumer
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 12/17/2025
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 NumberCAT00776
Device Lot Number010492
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 09/01/2025
Supplement Date Received by Manufacturer12/05/2025
Initial Report FDA Received Date09/29/2025
Supplement Report FDA Received Date12/17/2025
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 Age42 YR
Patient SexFemale
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