MAUDE Adverse Event Report: ASPEN SURGICAL PRODUCTS, INC. STERILE TIP CLEANER; CAUTERY TIP CLEANER

Model Number	TC-100
Medical Device Problem Code	Unsealed Device Packaging (1444)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
The part was just returned for evaluation, and the investigation is ongoing.Once additional relevant information is identified, it will be submitted in a supplemental report.
Event or Problem Description
Complainant alleges "sterilized failure".
Additional Manufacturer Narrative
The device was returned for evaluation.The seal failures were due to part interference, preventing a proper seal in the pouch.This may have been due to malfunctioning protrusion detection, operator not remdiating the protruding product, product not being loaded properly, or air flow cuasing the light weight product to ligt out of the pocket.The root cause was manufacturing error.If any additional relevant information is identified it will be submitted in a supplemental report.

• Brand Name: STERILE TIP CLEANER
• Common Device Name: CAUTERY TIP CLEANER
• Manufacturer (Section D): ASPEN SURGICAL PRODUCTS, INC.; 6945 southbelt dr se; caledonia MI 49316
• Manufacturer Contact: terry hall ; 6945 southbelt dr se; caledonia, MI 49316 ; 6166987100
• MDR Report Key: 23479367
• Report Number: 3002750084-2025-00058
• Device Sequence Number: 10499044
• Product Code: GEI
• UDI-Device Identifier: 00840113227051
• UDI-Public: 00840113227051
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• PMA/510(K) Number: K030339
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign,Distributor
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 01/22/2026

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: Other
• Device Model Number: TC-100
• Device Lot Number: 483030, 483029
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 11/04/2025
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 10/07/2025
• Supplement Date Received by Manufacturer: Not provided
• Initial Report FDA Received Date: 11/05/2025
• Supplement Report FDA Received Date: 01/22/2026
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• 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 Number: 1
• Patient Sex: Unknown