| 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
|
|
+1(888)888-3433
|
|
| MDR Report Key | 50237766 |
| Report Number | 0001056128-2026-00058 |
| Device Sequence Number | 13355623 |
| Product Code |
NLM
|
| UDI-Device Identifier | 00885825017248 |
| UDI-Public | (01)00885825017248(17)260910(10)17109620 |
| Combination Product (Y/N) | N |
| Initial Reporter Country | US |
| PMA/510(K) Number | K201511 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Health Professional |
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
09/23/2026 |
| 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 Expiration Date | 09/10/2026 |
| Device Catalogue Number | 2B5LT |
| Device Lot Number | 17109620 |
| Was Device Available for Evaluation? |
Yes
|
| Date Returned to Manufacturer | 07/27/2026 |
| Is the Reporter a Health Professional? |
No
|
| Initial Date Received by Manufacturer | 07/15/2026 |
| Supplement Date Received by Manufacturer | 08/26/2026
|
| Initial Report FDA Received Date | 08/13/2026 |
| Supplement Report FDA Received Date | 09/23/2026
|
| Was Device Evaluated by Manufacturer? (Y/N) |
Yes
|
| Date Device Manufactured | 09/10/2025 |
| 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) |
Yes
|
| Usage of Device |
Reuse
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |