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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG L11 LED LIGHT SOURCE WITH AIM; CONFOCAL OPTICAL IMAGING

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STRYKER ENDOSCOPY-SAN JOSE PKG L11 LED LIGHT SOURCE WITH AIM; CONFOCAL OPTICAL IMAGING Back to Search Results
Catalog Number 0220230300
Medical Device Problem Codes Optical Problem (3001); Output Problem (3005)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/09/2025
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 light disappeared about two hours into the procedure.Procedure completed using replacement.They have inspected the fse and were unable to reproduce the reported defect.They are currently conducting ongoing observation at the facility.
 
Additional Manufacturer Narrative
It was reported that the device was not available for evaluation.This complaint investigation was closed based on the device not received, therefore the reported failure mode was not confirmed.In the event that the device is received, the complaint will be reopened and the investigation will be updated with new results.Alleged failure: light disappeared about two hours into the procedure.Procedure completed using replacement.Probable root cause: light engine malfunction, main board, receptacle board, or front board malfunction, damaged or missing esst spring, incorrect/no communication with 1688, overheating, power supply malfunction, software malfunction, hf/rf interference, cybersecurity attack.The product was returned for investigation and the reported failure mode was confirmed.The failure mode will be monitored for future reoccurrence.
 
Event or Problem Description
It was reported that light disappeared about two hours into the procedure.Procedure completed using replacement.They have inspected the fse and were unable to reproduce the reported defect.They are currently conducting ongoing observation at the facility.
 
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Brand Name
PKG L11 LED LIGHT SOURCE WITH AIM
Common Device Name
CONFOCAL OPTICAL IMAGING
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 Key24700344
Report Number0002936485-2026-00183
Device Sequence Number10557194
Product Code OWN
UDI-Device Identifier07613327455915
UDI-Public07613327455915
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K182160
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) 04/29/2026
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 Number0220230300
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 12/09/2025
Supplement Date Received by Manufacturer03/30/2026
Initial Report FDA Received Date03/26/2026
Supplement Report FDA Received Date04/29/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured05/01/2021
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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