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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER-ENDOSCOPY LAKELAND 5300; LAPAROSCOPE, GENERAL & PLASTIC SURGERY, REPROCESSED

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STRYKER-ENDOSCOPY LAKELAND 5300; LAPAROSCOPE, GENERAL & PLASTIC SURGERY, REPROCESSED Back to Search Results
Model Number B5LT
Medical Device Problem Code Fracture (1260)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 03/04/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The device was returned to stryker sustainability solutions for evaluation.The complaint device was received opened.The complaint device was returned with the obturator blade collar fractured/broken at the obturator base.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 inspections and test criteria prior to release from stryker.The reported event could be attributed to: - excessive force applied contact with hard object or other improper handling insufficient structural integrity shipping/handling damage or extreme conditions.The instructions for use (ifu) state: - damage to the instrument can lead to patient injuries.Always inspect instrument carefully for overall integrity before use.Do not use excessive force.Careful handling of instruments is necessary to avoid damage or breakage.Inspect the instruments for any damage.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.A comprehensive understanding of the principles and techniques involved in laser, electrosurgical, and ultrasonic procedures is essential to avoid shock and burn hazards to both patient and medical personnel and damage to the device or other medical instruments.The reported event will continue to be monitored through post-market surveillance.
 
Event or Problem Description
It was reported, "broken trocar." it was further reported the device was broken when they opened the packaging and was not used in a procedure.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 LAKELAND 5300
5300 region ct
lakeland FL 33815
Manufacturer (Section G)
STRYKER-ENDOSCOPY LAKELAND 5300
5300 region ct
lakeland FL 33815
Manufacturer Contact
arsalan rizvi
1810 w. drake drive
tempe, AZ 85283
8888883433
MDR Report Key25056535
Report Number0001056128-2026-00028
Device Sequence Number9427755
Product Code NLM
UDI-Device Identifier00885825014193
UDI-Public00885825014193
Combination Product (Y/N)N
Initial Reporter StateFL
Initial Reporter CountryUS
PMA/510(K) Number
K201511
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) 05/01/2026
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 NumberB5LT
Device Catalogue NumberB5LT
Device Lot Number17304084
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/12/2026
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 04/03/2026
Initial Report FDA Received Date05/01/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
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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