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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG., RESECTOR SHAVER BLADE, F - SERIES - 5.5MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE PKG., RESECTOR SHAVER BLADE, F - SERIES - 5.5MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Catalog Number 0375562000
Health Effect - Clinical Code No Known Impact Or Consequence To Patient (2692)
Date of Event 06/15/2018
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 there was foreign material in sterile packaging.
 
Additional Manufacturer Narrative
Alleged failure: unopened disposable arthroscopic shaver look like it had tissue in it.The failure identified in the investigation is consistent with the complaint record.The probable root cause/s could be environmental conditions, inadequate cleaning process, qc incoming and in-process inspections.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 there was foreign material in sterile packaging.
 
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Brand Name
PKG., RESECTOR SHAVER BLADE, F - SERIES - 5.5MM
Common Device Name
BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL
Manufacturer (Section D)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
MDR Report Key7694095
Report Number0002936485-2018-00532
Device Sequence Number13614397
Product Code GFA
UDI-Device Identifier07613327061871
UDI-Public07613327061871
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source company representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 10/03/2018
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 Other
Device Catalogue Number0375562000
Device Lot Number17261CE2
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/26/2018
Initial Date Received by Manufacturer 06/20/2018
Supplement Date Received by Manufacturer06/20/2018
Initial Report FDA Received Date07/17/2018
Supplement Report FDA Received Date10/03/2018
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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