| Brand Name | PKG. WEDGE HS SUTURE ANCHOR II 5.0MM |
| Common Device Name | FASTENER, FIXATION, NONDEGRADABLE, SOFT TISSUE |
| 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 Key | 24533797 |
| Report Number | 0002936485-2026-00146 |
| Device Sequence Number | 13029484 |
| Product Code |
MBI
|
| UDI-Device Identifier | 37613154015307 |
| UDI-Public | 37613154015307 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | US |
| PMA/510(K) Number | K041310 |
| Number of Events Summarized | 1 |
| 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) |
05/29/2026 |
| 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 Number | 3910-100-035 |
| Device Lot Number | 24038AE2 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Initial |
| Initial Date Received by Manufacturer | 02/06/2026 |
| Supplement Date Received by Manufacturer | 05/18/2026
|
| Initial Report FDA Received Date | 03/06/2026 |
| Supplement Report FDA Received Date | 05/29/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 02/07/2024 |
| 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 |
|
|