STRYKER AHTO TUBE SET WITH TIP PACKAGING 0250070620

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a company representative report with the FDA on 2020-01-07 for STRYKER AHTO TUBE SET WITH TIP PACKAGING 0250070620 manufactured by Stryker Endoscopy-san Jose.

Event Text Entries

[179317188] Additional information will be provided once the investigation has been completed.
Patient Sequence No: 1, Text Type: N, H10


[179317189] It was reported that foreign material was found inside the sterile packaging.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number0002936485-2020-00008
MDR Report Key9559293
Report SourceCOMPANY REPRESENTATIVE
Date Received2020-01-07
Date of Report2020-03-10
Date of Event2019-12-13
Date Mfgr Received2019-12-13
Device Manufacturer Date2019-10-09
Date Added to Maude2020-01-07
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 FDA3
Event Location3
Manufacturer ContactMR. CHESTER REBUGIO
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 NameSTRYKER AHTO TUBE SET WITH TIP PACKAGING
Generic NameAPPARATUS, SUCTION, OPERATING-ROOM, WALL VACUUM POWERED
Product CodeGCX
Date Received2020-01-07
Returned To Mfg2019-12-27
Catalog Number0250070620
Lot Number19221FG2
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 2020-01-07

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