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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER-ENDOSCOPY TIJUANA MX; LAPAROSCOPE, GENERAL & PLASTIC SURGERY, REPROCESSED

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STRYKER-ENDOSCOPY TIJUANA MX; LAPAROSCOPE, GENERAL & PLASTIC SURGERY, REPROCESSED Back to Search Results
Model Number CTI-512N
Medical Device Problem Codes Break (1069); Use of Device Problem (1670); Material Integrity Problem (2978)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/23/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was returned to stryker sustainability solutions for evaluation.The returned complaint device was received with the stryker sustainability packaging.Visual inspection revealed the presence of a yellow residue on the device surface.The device was returned disassembled into multiple components, including the handle, plunger pin, and shaft, all of which were fully separated from one another.Where the shaft and handle come together the plastic cylinder plastic was broken.At the interface where the shaft and handle assemble, the plastic cylindrical component was found a portion of the material missing on one side.Additional small fractures were observed along the lower section of the plastic component.The device inspection indicated that the complaint was confirmed for the reported failure mode.A review of the dhr supports that the device met all inspection and test criteria prior to release from stryker.The reported event could be attributed to: excessive force, contact of needle point with hard object, shipping/handling damage or extreme conditions, attempting to bend or otherwise alter the shape of the device/shaft.The instructions for use (ifu) state: "before beginning the procedure, verify overall compatibility of all instruments and accessories." "inspect the instrument for overall condition and physical integrity.Do not use the instrument if any damage is noted.Return the instrument and packaging to stryker sustainability solutions if it is not in acceptable condition for surgery." the reported event will continue to be monitored through post-market surveillance.
 
Event or Problem Description
It was reported the device "exploded" into several pieces when on the sterile field.It was further reported there was no harm to the patient, but the part just sprang all over the place.There was no patient injury, medical intervention, or extended procedure time reported.These are commonly used devices that are readily available.
 
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Brand Name
NA
Common Device Name
LAPAROSCOPE, GENERAL & PLASTIC SURGERY, REPROCESSED
Manufacturer (Section D)
STRYKER-ENDOSCOPY TIJUANA MX
ave todos los santos no. 10802
col. leandro valle, baja ca
tijuana
Manufacturer (Section G)
STRYKER-ENDOSCOPY TIJUANA MX
ave todos los santos no. 10802
col. leandro valle, baja ca
tijuana
Manufacturer Contact
arsalan rizvi
1810 w. drake drive
tempe, AZ 85283
8888883433
MDR Report Key24670779
Report Number3020163307-2026-00001
Device Sequence Number13097550
Product Code NLM
UDI-Device Identifier00885825013318
UDI-Public00885825013318
Combination Product (Y/N)N
Initial Reporter StateOK
Initial Reporter CountryUS
PMA/510(K) Number
K053585
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial
Report Date (Section B) 03/23/2026
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 Model NumberCTI-512N
Device Catalogue NumberCTI-512N
Device Lot Number0001261952
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/05/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/23/2026
Initial Report FDA Received Date03/23/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/20/2026
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)
Yes
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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