FORMULA 0375940200 0375-940-200

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-27 for FORMULA 0375940200 0375-940-200 manufactured by Stryker Endoscopy.

Event Text Entries

[185223692] Discovered what appears to be a hair within the seal of the packaging - part of contaminant inside packaging with device and part of contaminant outside the packaging. Package not opened; no patient exposure.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9888151
MDR Report Key9888151
Date Received2020-03-27
Date of Report2020-03-25
Date of Event2020-03-25
Report Date2020-03-26
Date Reported to FDA2020-03-26
Date Reported to Mfgr2020-03-27
Date Added to Maude2020-03-27
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag0
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameFORMULA
Generic NameBLADE, SAW, GENERAL PLASTIC SURGERY, SURGICAL
Product CodeGFA
Date Received2020-03-27
Model Number0375940200
Catalog Number0375-940-200
Lot Number18277CE2
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Age1 DA
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerSTRYKER ENDOSCOPY
Manufacturer Address5900 OPTICAL CT SAN JOSE CA 95138 US 95138


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-27

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