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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: STRYKER ENDOSCOPY-SAN JOSE PKG., BARREL BUR, 6 FLUTE F - SERIES - 4.0MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL

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STRYKER ENDOSCOPY-SAN JOSE PKG., BARREL BUR, 6 FLUTE F - SERIES - 4.0MM; BLADE, SAW, GENERAL & PLASTIC SURGERY, SURGICAL Back to Search Results
Catalog Number 0375941000
Medical Device Problem Code Device Contaminated During Manufacture or Shipping (2969)
Health Effect - Clinical Code No Patient Involvement (2645)
Date of Event 12/14/2019
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 inside the sterile packaging.
 
Event or Problem Description
It was reported that there was foreign material inside the sterile packaging.
 
Additional Manufacturer Narrative
This complaint investigation was closed based on the device not received, therefore the reported failure mode was not confirmed.In the event that the device is received, the complaint will be reopened and the investigation will be updated with new results.Alleged failure: foreign material inside sterile packaging.Probable root cause: foreign material left in the device stains corrosion inadequate cleaning process environmental conditions dents scratches shipping damage the reported failure mode will be monitored for future reoccurrence.
 
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Brand Name
PKG., BARREL BUR, 6 FLUTE F - SERIES - 4.0MM
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 Key9564716
Report Number0002936485-2020-00013
Device Sequence Number19318269
Product Code GFA
UDI-Device Identifier37613327054744
UDI-Public37613327054744
Combination Product (Y/N)N
Initial Reporter CountryGB
PMA/510(K) Number
EXEMPT
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source health professional
Initial Reporter Occupation Nurse
Type of Report Initial,Followup
Report Date (Section B) 03/06/2020
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 Number0375941000
Device Lot Number19158CE2
Was Device Available for Evaluation? No
Initial Date Received by Manufacturer 12/18/2019
Supplement Date Received by Manufacturer12/18/2019
Initial Report FDA Received Date01/08/2020
Supplement Report FDA Received Date03/06/2020
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Patient Sequence Number1
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