5.0MM X 10FT CLEAR CASE FIBEROPTIC LIGHT CABLE 0233050064

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 00 report with the FDA on 2013-06-03 for 5.0MM X 10FT CLEAR CASE FIBEROPTIC LIGHT CABLE 0233050064 manufactured by Stryker Endoscopy-san Jose.

Event Text Entries

[3523825] It was reported that the light cable was used with another manufacturer light source resulting in patient burns.
Patient Sequence No: 1, Text Type: D, B5


[3929158] It was reported that the light cable was used with another manufacture light source resulting in patient burns.
Patient Sequence No: 1, Text Type: D, B5


[10796902] Additional information will be provided once investigation has been completed.
Patient Sequence No: 1, Text Type: N, H10


[11231315] The product was not returned for investigation. The reported failure mode could not be confirmed. Based on the event description, the probable root cause could be attributed to incorrect light output emitted by the competitor light source. However, this cannot be confirmed since the unit has not been returned. Additionally, stryker does not indicate compatibility of the light cable with a competitor light source. In sum, the product was not returned for investigation and the reported failure mode could not be confirmed. The failure mode will be monitored for future reoccurrence.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number0002936485-2013-00244
MDR Report Key3143570
Report Source00
Date Received2013-06-03
Date of Report2013-05-22
Date of Event2011-06-01
Date Mfgr Received2013-05-22
Date Added to Maude2013-06-04
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Manufacturer ContactMR. THOMAS SHAFER
Manufacturer Street5900 OPTICAL COURT
Manufacturer CitySAN JOSE CA 95138
Manufacturer CountryUS
Manufacturer Postal95138
Manufacturer Phone4087542000
Manufacturer G1STRYKER ENDOSCOPY-SAN JOSE
Manufacturer Street5900 OPTICAL COURT
Manufacturer CitySAN JOSE CA 95138
Manufacturer CountryUS
Manufacturer Postal Code95138
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand Name5.0MM X 10FT CLEAR CASE FIBEROPTIC LIGHT CABLE
Generic NameLIGHT, SURGICAL, FLOOR STANDING
Product CodeFSS
Date Received2013-06-03
Catalog Number0233050064
Lot NumberUNK
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrN
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER ENDOSCOPY-SAN JOSE
Manufacturer Address5900 OPTICAL COURT SAN JOSE CA 95138 US 95138


Patients

Patient NumberTreatmentOutcomeDate
10 2013-06-03

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