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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG CONNECTED OR HUB BASE SYSTEM; LAPAROSCOPE, GENERAL & PLASTIC SURGERY

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STRYKER ENDOSCOPY-SAN JOSE PKG CONNECTED OR HUB BASE SYSTEM; LAPAROSCOPE, GENERAL & PLASTIC SURGERY Back to Search Results
Catalog Number 0240200200
Medical Device Problem Codes Overheating of Device (1437); Electrical Power Problem (2925)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 11/13/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Alleged failure: the hub shorted out and started smoking when in use today.The failure identified in the investigation is consistent with the complaint record.The probable root cause can be attributed to a power supply failure.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that hub shorted out and started smoking when in use.Hence it is a thermal event.
 
Additional Manufacturer Narrative
Alleged failure: his hub shorted out and started smoking when in use today.The failure identified in the investigation is consistent with the complaint record.The probable root cause can be attributed to a power supply failure.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that hub shorted out and started smoking when in use.Hence it is a thermal event.
 
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Brand Name
PKG CONNECTED OR HUB BASE SYSTEM
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 Key23781863
Report Number0002936485-2025-00979
Device Sequence Number18686634
Product Code GCJ
UDI-Device Identifier07613327601695
UDI-Public07613327601695
Combination Product (Y/N)N
Initial Reporter StateNY
Initial Reporter CountryUS
PMA/510(K) Number
K241401
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) 12/30/2025
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 Number0240200200
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/19/2025
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 11/13/2025
Supplement Date Received by Manufacturer12/11/2025
Initial Report FDA Received Date12/11/2025
Supplement Report FDA Received Date12/30/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/01/2025
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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