FDA Adverse Event Malfunction Summary report: N

PKG PRECISION LED LIGHT SOURCE

MDR report key: 21251810 · Received January 28, 2025

Report

Report Number
0002936485-2025-00063
Event Type
Malfunction
Date Received
January 28, 2025
Date of Event
January 16, 2025
Report Date
May 22, 2025
Manufacturer
STRYKER ENDOSCOPY-SAN JOSE
Product Code
FCW
UDI-DI
07613327051322
PMA / PMN Number
K082813
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
FR
Reporter Occupation
117

Narratives

Additional Manufacturer Narrative · 0

ADDITIONAL INFORMATION WILL BE PROVIDED ONCE THE INVESTIGATION HAS BEEN COMPLETED.

Additional Manufacturer Narrative · 0

THE DEVICE WAS NOT RECEIVED FOR INVESTIGATION AT STRYKER ENDOSCOPY BECAUSE IT WAS REPAIRED LOCALLY IN STRYKER FRANCE THE TECHNICAL SERVICE REPORT INDICATES: FAULT : ERROR MESSAGE E2 AND BLUE LIGHT REPAIR LEVEL : 1 ACTION TAKEN : REPLACE LED MODULE REPLACE ACTUATOR TESTS : FUNCTION TEST CALIBRATION GENERAL INSPECTIONS QIP" PROBABLE ROOT CAUSE: FRONT BOARD MALFUNCTION TOUCH SCREEN MALFUNCTION MAIN BOARD MALFUNCTION POWER SUPPLY MALFUNCTION AC INLET BOARD MALFUNCTION POWER BUTTON ROD DAMAGED INADEQUATE AIR FLOW SIDNE PORT MALFUNCTION POOR WORKMANSHIP USE ERRORS ELECTROMAGNETIC INTERFERENCE (EMI) FROM RF COMMUNICATION, HF SURGICAL INSTRUMENTS, ESD, OR POWER SURGE THE REPORTED FAILURE MODE WILL BE MONITORED FOR FUTURE REOCCURRENCE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THERE WAS LOSS OF LIGHT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THERE WAS LOSS OF LIGHT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1441493 PKG PRECISION LED LIGHT SOURCE LIGHT SOURCE, FIBEROPTIC, ROUTINE FCW STRYKER ENDOSCOPY-SAN JOSE 07613327051322

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown