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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE SERFAS ENERGY 90-S CRUISE; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES

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STRYKER ENDOSCOPY-SAN JOSE SERFAS ENERGY 90-S CRUISE; ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Catalog Number 0279401200
Medical Device Problem Code Device Contaminated at the User Facility (4064)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/09/2026
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 the customer observed black, sticky stuff on the cord (sealed).It was during set up when the scrub tech was taking it out of the packaging.The package was sealed.There was no delay in case.
 
Additional Manufacturer Narrative
Alleged failure: customer observed black, sticky stuff on the cord (sealed) and wants to return for a credit.The failure(s) identified in the investigation is consistent with the complaint record.The probable root cause could be an inadequate cleaning process, improper handling, or exposure to unfavorable environmental conditions that may have contributed to the residue.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that the customer observed black, sticky stuff on the cord (sealed).It was during set up when the scrub tech was taking it out of the packaging.The package was sealed.There was no delay in case.
 
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Brand Name
SERFAS ENERGY 90-S CRUISE
Common Device Name
ELECTROSURGICAL, CUTTING & COAGULATION & ACCESSORIES
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 Key24373134
Report Number0002936485-2026-00098
Device Sequence Number17561888
Product Code GEI
UDI-Device Identifier07613327057034
UDI-Public07613327057034
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K160050
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Distributor
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 04/06/2026
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 Number0279401200
Device Lot Number25127AE2
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/27/2026
Is the Reporter a Health Professional? No
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/20/2026
Supplement Date Received by Manufacturer03/24/2026
Initial Report FDA Received Date02/17/2026
Supplement Report FDA Received Date04/06/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/07/2025
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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