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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Stryker Endoscopy-San Jose PKG 1788 4K INLINE CAMERA HEAD C-MOUNT; Laparoscope, General & Plastic Surgery

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Stryker Endoscopy-San Jose PKG 1788 4K INLINE CAMERA HEAD C-MOUNT; Laparoscope, General & Plastic Surgery Back to Search Results
Catalog Number 1788710105
Medical Device Problem Code No Display/Image (1183)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/19/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the image was cycling through white balance, video loading, and the displayed video on the monitor.The video issue was resolved as soon as the camera was replaced.Therefore, there was a full loss of image.
 
Additional Manufacturer Narrative
Additional information will be provided once the investigation has been completed.
 
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Brand Name
PKG 1788 4K INLINE CAMERA HEAD C-MOUNT
Common Device Name
Laparoscope, General & Plastic Surgery
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
+1(408)754-2000
MDR Report Key50794840
Report Number0002936485-2026-01020
Device Sequence Number16081030
Product Code GCJ
UDI-Device Identifier07613327580082
UDI-Public07613327580082
Combination Product (Y/N)N
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
K230605
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Company Representative
Type of Report Initial
Report Date (Section B) 09/16/2026
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 Number1788710105
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer08/28/2026
Is the Reporter a Health Professional? No
Initial Date Received by Manufacturer 08/19/2026
Initial Report FDA Received Date09/16/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/01/2023
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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