MAUDE Adverse Event Report: STRYKER INSTRUMENTS-KALAMAZOO FLYTE SURGICOOL HOOD, PEELAWAY; HOOD, SURGICAL

Catalog Number	0408801500
Medical Device Problem Code	Material Integrity Problem (2978)
Health Effect - Clinical Code	No Consequences Or Impact To Patient (2199)
Date of Event	01/01/2019
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
This record is a consolidation of records summarized as a part of the fda voluntary malfunction summary reporting program.Reported events: 2 events were reported for this quarter.Product return status; 1 device was not available for evaluation.1 device investigation type has not yet been determined. dditional information: 2 devices were labeled for single-use.2 devices were not reprocessed and reused.
Event or Problem Description
This report summarizes 2 malfunction events in which the material integrity of the device was reportedly compromised.2 events had patient involvement; no patient impact.
Event or Problem Description
This report summarizes 2 malfunction events in which the material integrity of the device was reportedly compromised.2 events had patient involvement; no patient impact.
Additional Manufacturer Narrative
This record is a consolidation of records summarized as a part of the fda voluntary malfunction summary reporting program.Supplemental rationale 2 previously reported events are included in this follow-up record.Product return status 1 device was received.1 device was not available for evaluation.Event confirmation status 1 reported event was not confirmed.Evaluation results 1 device had no problem found.

• Brand Name: FLYTE SURGICOOL HOOD, PEELAWAY
• Common Device Name: HOOD, SURGICAL
• Manufacturer (Section D): STRYKER INSTRUMENTS-KALAMAZOO; 4100 east milham avenue; kalamazoo MI 49001
• MDR Report Key: 8546488
• Report Number: 0001811755-2019-01506
• Device Sequence Number: 13545049
• Product Code: FXY
• UDI-Device Identifier: 37613252661086
• UDI-Public: 37613252661086
• Combination Product (Y/N): N
• Initial Reporter State: MI
• Initial Reporter Country: US
• Number of Events Summarized: 2
• Summary Report (Y/N): Y
• Reporter Type: Manufacturer
• Report Source: company representative
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 07/26/2019

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: No Information
• Device Catalogue Number: 0408801500
• Was Device Available for Evaluation?: No
• Initial Date Received by Manufacturer: 01/01/2019
• Supplement Date Received by Manufacturer: 01/01/2019
• Initial Report FDA Received Date: 04/24/2019
• Supplement Report FDA Received Date: 07/26/2019
• Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N): No
• Patient Sequence Number: 1