FDA Adverse Event Malfunction Summary report: N

PKG, CONNECTED OR HUB BASE SYSTEM

MDR report key: 17695286 · Received September 6, 2023

Report

Report Number
0002936485-2023-00898
Event Type
Malfunction
Date Received
September 6, 2023
Date of Event
August 7, 2023
Report Date
July 12, 2024
Manufacturer
STRYKER ENDOSCOPY-SAN JOSE
Product Code
GCJ
UDI-DI
07613327413281
PMA / PMN Number
K222079
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FL, US
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

THIS COMPLAINT INVESTIGATION WAS CLOSED BASED ON THE DEVICE NOT RECEIVED, THEREFORE THE REPORTED FAILURE MODE WAS NOT CONFIRMED ALLEGED FAILURE: FLICKERING PROBABLE ROOT CAUSE: CABLES, CONNECTORS, SOURCES, OR SINKS. CAPTURE CARD, MOTHERBOARD, POWER SUPPLY. SDC FIRMWARE. OVER-HEATING. (AIR DUCT, FANS, HEAT SINKS, DUST, VENTS) SDC APPLICATION SOFTWARE, CLARITY PACKAGE. CLARITY ALGORITHM. MANUFACTURING DEFECTS. (PROCESS, WORKMANSHIP) USE ERROR. PROBABLE ROOT CAUSE: CABLES, CONNECTORS, SOURCES, OR SINKS. CAPTURE CARD, MOTHERBOARD, POWER SUPPLY. SDC FIRMWARE. OVER-HEATING. (AIR DUCT, FANS, HEAT SINKS, DUST, VENTS) SDC APPLICATION SOFTWARE, CLARITY PACKAGE. CLARITY ALGORITHM. MANUFACTURING DEFECTS. (PROCESS, WORKMANSHIP) MANUFACTURE DATE IS NOT KNOWN THE REPORTED FAILURE MODE WILL BE MONITORED FOR FUTURE REOCCURRENCE.

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION WILL BE PROVIDED ONCE THE INVESTIGATION HAS BEEN COMPLETED. THE DEVICE MANUFACTURER DATE IS NOT KNOWN AT THIS TIME. HOWEVER, SHOULD IT BECOME AVAILABLE IT WILL BE PROVIDED IN FUTURE REPORTS.

Description of Event or Problem · 0

IT WAS REPORTED THAT THERE WAS LOSS OF IMAGE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THERE WAS LOSS OF IMAGE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1170787 PKG, CONNECTED OR HUB BASE SYSTEM LAPAROSCOPE, GENERAL & PLASTIC SURGERY GCJ STRYKER ENDOSCOPY-SAN JOSE 07613327413281

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown