X7000 XENON LIGHTSOURCE 0220190000

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 07 report with the FDA on 2014-08-05 for X7000 XENON LIGHTSOURCE 0220190000 manufactured by Stryker Endoscopy-san Jose.

Event Text Entries

[17616861] It was reported that the lightsource automatically switched to standby intermittently. The procedure was later switched to an open surgery.
Patient Sequence No: 1, Text Type: D, B5


[17811748] Additional information will be provided once the investigation has been completed.
Patient Sequence No: 1, Text Type: N, H10


[30273333] X7000 s/n (b)(4) was returned to stryker for analysis, but the failure mode was not confirmed. The customer complaint of? Switched to standby? Could not be duplicated. Visual inspection: there were no outward signs of cosmetic or physical damage to the product. Functional inspection: all measurements and functionality testing met specification. Probable root cause: could not duplicate the complaint in our test environment. In sum, the unit was returned, but the failure mode was not confirmed.
Patient Sequence No: 1, Text Type: N, H10


[30273334] It was reported that the lightsource automatically switched to standby intermittently. The procedure was later switched to an open surgery.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0002936485-2014-00576
MDR Report Key3982333
Report Source07
Date Received2014-08-05
Date of Report2014-07-09
Date of Event2014-07-09
Date Mfgr Received2014-07-09
Date Added to Maude2014-08-14
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 NameX7000 XENON LIGHTSOURCE
Generic NameLIGHT, SURGICAL, FLOOR STANDING
Product CodeFSS
Date Received2014-08-05
Returned To Mfg2014-07-28
Catalog Number0220190000
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device AgeDA
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER ENDOSCOPY-SAN JOSE
Manufacturer Address5900 OPTICAL COURT SAN JOSE CA 95138 US 95138


Patients

Patient NumberTreatmentOutcomeDate
10 2014-08-05

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