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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 Device Contaminated During Manufacture or Shipping (2969)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/15/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
Event or Problem Description
It was reported that debris was found inside the sterile package upon opening.
 
Additional Manufacturer Narrative
Alleged failure: per customer debris found inside sterile package upon opening the failure(s) identified in the investigation is consistent with the complaint record.The probable root causes could be the was dirty or the packagers hand had contaminants during packaging.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that debris was found inside the sterile package upon opening.
 
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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 Key24056830
Report Number0002936485-2026-00024
Device Sequence Number9421601
Product Code GCJ
UDI-Device Identifier37613327061391
UDI-Public37613327061391
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 Other,Distributor
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 04/29/2026
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 Health Professional
Device Catalogue Number0250070500
Device Lot Number25201FG2
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer12/19/2025
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 12/15/2025
Supplement Date Received by Manufacturer04/13/2026
Initial Report FDA Received Date01/13/2026
Supplement Report FDA Received Date04/29/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured07/20/2025
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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