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 05 report with the FDA on 2014-03-18 for 5.0MM X 10FT CLEAR CASE FIBEROPTIC LIGHT CABLE 0233050064 manufactured by Stryker Endoscopy-san Jose.

Event Text Entries

[4242504] It was reported that the light cable, which was plugged into a light source, burnt the thumb of the scrub tech near the end of a hysterectomy procedure when the user was switching from a laparoscopic scope to a cystoscope.
Patient Sequence No: 1, Text Type: D, B5


[4717653] It was reported that the light cable, which was plugged into a light source, burnt the thumb of the scrub tech near the end of a hysterectomy procedure when the user was switching from a laparoscopic scope to a cystoscope.
Patient Sequence No: 1, Text Type: D, B5


[11572434] Additional information will be provided once the investigation has been completed.
Patient Sequence No: 1, Text Type: N, H10


[12312258] The device was not returned to stryker endo for investigation, therefore, the failure mode could not be confirmed. The complaint will be closed without a detailed investigation report and based on probable root cause. In the event that the device is received, the complaint will be reopened, a full evaluation will be conducted, and the investigation will be updated with the new results. Probable root cause for the reported failure involving this device could have been caused by a lightsource malfunction and/or user error. 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 Number0002936485-2014-00140
MDR Report Key3684208
Report Source05
Date Received2014-03-18
Date of Report2014-02-25
Date of Event2014-02-25
Date Mfgr Received2014-02-25
Date Added to Maude2014-03-18
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag0
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
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 Received2014-03-18
Catalog Number0233050064
Lot Number233-050-064
OperatorHEALTH PROFESSIONAL
Device AvailabilityN
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER ENDOSCOPY-SAN JOSE
Manufacturer Address5900 OPTICAL COURT SAN JOSE CA 95138 US 95138


Patients

Patient NumberTreatmentOutcomeDate
10 2014-03-18

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