FDA Adverse Event Malfunction Summary report: N

FG SAFELIGHT FIBER OPTIC CABLE WITH ADVANCED IMAGING MODALITY RIGHT ANGLE 5 MM

MDR report key: 21529700 · Received March 5, 2025

Report

Report Number
0002936485-2025-00164
Event Type
Malfunction
Date Received
March 5, 2025
Date of Event
February 17, 2025
Report Date
June 10, 2025
Manufacturer
STRYKER ENDOSCOPY-SAN JOSE
Product Code
OWN
UDI-DI
07613327462760
PMA / PMN Number
K192292
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
JA
Reporter Occupation
NURSE
Health Professional
Yes

Narratives

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.

Additional Manufacturer Narrative · 0

UPDATED G4 PMA/510(K) TO K192292. UPDATED H6 MEDICAL DEVICE PROBLEM TO OVERHEATING OF DEVICE. THIS COMPLAINT INVESTIGATION WAS CLOSED BASED ON THE DEVICE NOT RECEIVED, THEREFORE THE REPORTED FAILURE MODE WAS NOT CONFIRMED. MULTIPLE ATTEMPTS HAVE BEEN MADE TO RETRIEVE THE DEVICE FOR EVALUATION, AND IT IS YET TO BE RECEIVED IN-HOUSE. IN THE EVENT THAT THE DEVICE IS RECEIVED, THE COMPLAINT WILL BE REOPENED AND THE INVESTIGATION WILL BE UPDATED WITH NEW RESULTS. ALLEGED FAILURE: TOO MUCH HEAT. PROBABLE ROOT CAUSE: REED SWITCH ASSEMBLY MALFUNCTION USE ERROR. THE DEVICE MANUFACTURER DATE IS NOT KNOWN. THE REPORTED FAILURE MODE WILL BE MONITORED FOR FUTURE REOCCURRENCE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THERE WAS A THERMAL EVENT.

Description of Event or Problem · 0

IT WAS REPORTED THAT THERE WAS A THERMAL EVENT.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
2630413 FG SAFELIGHT FIBER OPTIC CABLE WITH ADVANCED IMAGING MODALITY RIGHT ANGLE 5 MM CONFOCAL OPTICAL IMAGING OWN STRYKER ENDOSCOPY-SAN JOSE 07613327462760

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown