MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a health professional report with the FDA on 2020-02-26 for HARH36 HARH36RR manufactured by Stryker Sustainability Solutions Lakeland.
[182706282]
The device was returned to stryker sustainability solutions for evaluation. Upon visual inspection of the received complaint device, evidence of clinical use was identified. The distal end of the blade was fractured and separated from the rest of the device. The separated portion of the blade was not returned with the device. The teflon pad, jaw, handle and contact rings appeared to be intact. A review of the device history record (dhr) confirmed the device met all inspection and testing requirements prior to distribution. Therefore, the most likely root causes are: jaws/blade subassembly damage incidental and prolonged activation against solid surfaces, such as bone or plastic the instructions for use (ifu) state: use the torque wrench (already mounted to the shaft) to tighten the blade onto the hand piece. Turn the torque wrench clockwise while holding only the gray hand piece until it clicks twice indicating that sufficient torque has been applied to secure the blade. Do not attempt to bend, sharpen, or otherwise alter the shape of the blade. Doing so may cause blade failure and user or patient injury. Avoid contact with any and all other instruments while the instrument is activated. Contact with staples, clips or other instruments while the instrument is activated may result in cracked or broken blades. Note: do not use any other means than the torque wrench to attach or detach the instrument from the hand piece. Note: do not torque the instrument by hand without the torque wrench or damage may occur to the hand piece. The reported event will continue to be monitored through post-market surveillance.
Patient Sequence No: 1, Text Type: N, H10
[182706283]
It was reported the tip of the harmonic shear broke during the procedure. The tip was found lodged in the gastric sizing balloon. The balloon and tip were retrieved and a new sizing balloon was inserted and the procedure was completed without complication. There was no patient injury or extended procedure time reported. These are commonly used devices that are readily available.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 0001056128-2020-00009 |
| MDR Report Key | 9753595 |
| Report Source | HEALTH PROFESSIONAL |
| Date Received | 2020-02-26 |
| Date of Report | 2020-02-25 |
| Date of Event | 2020-01-28 |
| Date Mfgr Received | 2020-01-31 |
| Device Manufacturer Date | 2019-08-13 |
| Date Added to Maude | 2020-02-26 |
| Event Key | 0 |
| Report Source Code | Manufacturer report |
| Manufacturer Link | Y |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Reporter Occupation | OTHER HEALTH CARE PROFESSIONAL |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Manufacturer Contact | MR. MARISSA RICHMOND |
| Manufacturer Street | 1810 W. DRAKE DRIVE |
| Manufacturer City | TEMPE AZ 85283 |
| Manufacturer Country | US |
| Manufacturer Postal | 85283 |
| Manufacturer Phone | 8888883433 |
| Manufacturer G1 | STRYKER SUSTAINABILITY SOLUTIONS LAKELAND |
| Manufacturer Street | 5300 REGION CT |
| Manufacturer City | LAKELAND FL 33815 |
| Manufacturer Country | US |
| Manufacturer Postal Code | 33815 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 3 |
| Brand Name | NA |
| Generic Name | SCALPEL, ULTRASONIC, REPROCESSED |
| Product Code | NLQ |
| Date Received | 2020-02-26 |
| Returned To Mfg | 2020-02-14 |
| Model Number | HARH36 |
| Catalog Number | HARH36RR |
| Lot Number | 10733521 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | R |
| Device Eval'ed by Mfgr | Y |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | STRYKER SUSTAINABILITY SOLUTIONS LAKELAND |
| Manufacturer Address | 5300 REGION CT LAKELAND FL 33815 US 33815 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 1. Required No Informationntervention | 2020-02-26 |