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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG., AGG. PLUS SHAVER BLADE, F- SERIES - 4.0MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE PKG., AGG. PLUS SHAVER BLADE, F- SERIES - 4.0MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Catalog Number 0375544000
Device Problem Contamination /Decontamination Problem (2895)
Patient Problem No Known Impact Or Consequence To Patient (2692)
Event Date 08/28/2019
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.
 
Event Description
It was reported that there was foreign material in the sterile packaging.
 
Manufacturer Narrative
Manufacture date is not known.Alleged failure: a blue foreign material was found inside the package.The failure(s) identified in the investigation is consistent with the complaint record.The probable root cause/s could be improper cleaning process, qc incoming, and in-process inspections, environmental conditions.The product was returned for investigation and the failure mode will be monitored for future reoccurrence.
 
Event Description
It was reported that there was foreign material in the sterile packaging.
 
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Brand Name
PKG., AGG. PLUS SHAVER BLADE, F- SERIES - 4.0MM
Type of Device
BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL
Manufacturer (Section D)
STRYKER ENDOSCOPY-SAN JOSE
5900 optical court
san jose CA 95138
MDR Report Key9106454
MDR Text Key165305761
Report Number0002936485-2019-00415
Device Sequence Number1
Product Code GFA
UDI-Device Identifier37613327061780
UDI-Public37613327061780
Combination Product (y/n)N
PMA/PMN Number
EXEMPT
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type company representative
Type of Report Initial,Followup
Report Date 11/08/2019
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received09/23/2019
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Other
Device Catalogue Number0375544000
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/26/2019
Date Manufacturer Received08/29/2019
Is This a Reprocessed and Reused Single-Use Device? No
Patient Sequence Number1
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