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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG. ASSY. SUCTION IRRIGATOR 2; LAPAROSCOPE, GENERAL & PLASTIC SURGERY

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STRYKER ENDOSCOPY-SAN JOSE PKG. ASSY. SUCTION IRRIGATOR 2; LAPAROSCOPE, GENERAL & PLASTIC SURGERY Back to Search Results
Catalog Number 0250070500
Medical Device Problem Code Decrease in Pressure (1490)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/04/2025
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 as soon as the device was opened and used for the first time, continuous suction occurred.
 
Additional Manufacturer Narrative
Multiple attempts were made for additional information, however no new information was received.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: continuous suction.Probable root cause: severe shipping conditions.Material/design error.Damaged equipment.User error.The reported failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that as soon as the device was opened and used for the first time, continuous suction occurred.
 
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Brand Name
PKG. ASSY. SUCTION IRRIGATOR 2
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
arsalan rizvi
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key23353119
Report Number0002936485-2025-00865
Device Sequence Number9019214
Product Code GCJ
UDI-Device Identifier37613327061391
UDI-Public37613327061391
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Pharmacist
Type of Report Initial,Followup
Report Date (Section B) 12/22/2025
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 Number0250070500
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 09/22/2025
Supplement Date Received by Manufacturer12/08/2025
Initial Report FDA Received Date10/21/2025
Supplement Report FDA Received Date12/22/2025
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 SexUnknown
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