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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE ACL DISPOSABLE PACK BONE-TENDON-BONE; KIT, SURGICAL INSTRUMENT, DISPOSABLE

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STRYKER ENDOSCOPY-SAN JOSE ACL DISPOSABLE PACK BONE-TENDON-BONE; KIT, SURGICAL INSTRUMENT, DISPOSABLE Back to Search Results
Catalog Number 234-020-280
Device Problem Shelf Life Exceeded (1567)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 11/17/2017
Event Type  malfunction  
Manufacturer Narrative
Additional information will be provided once the investigation has been completed.The device manufacturer date is not known at this time.However, should it become available it will be provided in future reports.(b)(4).
 
Event Description
It was reported that an expired product was used.
 
Manufacturer Narrative
The product was not returned for investigation therefore the reported failure mode was not confirmed.The failure mode will be monitored for future reoccurrence.Alleged failure: expired lot used.Probable root cause: design: insufficient labeling design, insufficient shelf life validated.Application: use past device/packaging shelf life.Gtin: (b)(4).
 
Event Description
It was reported that an expired product was used.
 
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Brand Name
ACL DISPOSABLE PACK BONE-TENDON-BONE
Type of Device
KIT, SURGICAL INSTRUMENT, DISPOSABLE
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
valerie estrada
5900 optical court
san jose, CA 95138
4087542000
MDR Report Key7152356
MDR Text Key96115551
Report Number0002936485-2017-01256
Device Sequence Number1
Product Code KDD
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 04/19/2018
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received12/28/2017
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue Number234-020-280
Device Lot Number15318AG2
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Date Manufacturer Received12/08/2017
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Date Device Manufactured11/14/2015
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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