FDA Adverse Event Malfunction Summary report: N

FLOWPORT II CANNULA WITH OBTURATOR STRYKER 165MM

MDR report key: 21531878 · Received March 5, 2025

Report

Report Number
0002936485-2025-00174
Event Type
Malfunction
Date Received
March 5, 2025
Date of Event
February 6, 2025
Report Date
August 26, 2025
Manufacturer
STRYKER ENDOSCOPY-SAN JOSE
Product Code
NBH
UDI-DI
07613252633181
PMA / PMN Number
EXEMPT
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
SZ
Reporter Occupation
OTHER
Health Professional
N

Narratives

Additional Manufacturer Narrative · 0

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

Additional Manufacturer Narrative · 0

THREE ATTEMPTS HAVE BEEN MADE TO RETRIEVE THE DEVICE FOR EVALUATION, AND IT IS YET TO BE RECEIVED IN-HOUSE. NO FURTHER ATTEMPTS TO RETRIEVE THE DEVICE ARE REQUIRED. IN THE EVENT THAT THE DEVICE IS RECEIVED, THE COMPLAINT WILL BE REOPENED AND THE INVESTIGATION WILL BE UPDATED WITH THE NEW RESULTS. THIS COMPLAINT INVESTIGATION WAS CLOSED BASED ON THE DEVICE NOT RECEIVED, THEREFORE THE REPORTED FAILURE MODE WAS NOT CONFIRMED. IN THE EVENT THAT THE DEVICE IS RECEIVED, THE COMPLAINT WILL BE REOPENED AND THE INVESTIGATION WILL BE UPDATED WITH NEW RESULTS. ALLEGED FAILURE: TIP BREAKING PROBABLE ROOT CAUSE: APPLICATION - EXCESSIVE FORCE - POOR VISUALIZATION THROUGH ARTHROSCOPE THE REPORTED FAILURE MODE WILL BE MONITORED FOR FUTURE REOCCURRENCE.

Additional Manufacturer Narrative · 0

THE PRODUCT HAS NOW BEEN PHYSICALLY RECEIVED AT STRYKER ENDOSCOPY, USA AND THE INVESTIGATION HAS BEEN RE-OPENED. INVESTIGATION AS FOLLOWS IS NOW BASED ON PRODUCT RECEIVED. ALLEGED FAILURE: THE FLOWPORT II CANNULA (CAT 02438, LOT: 011393) BROKE OFF IN THE CAPSULE. PART OF IT FELL INTO THE ACETABULUM AND HAD TO BE RETRIEVED. TIME LOSS APPROX. 60 MIN. THE SECOND CANNULA FROM THE SAME KIT ALSO BROKE AFTER THE EXTENSION WAS COMPLETED. THE CANNULA WAS IN THE JOINT WITH THE OPTICS AND WAS SLIGHTLY CRUSHED. THE BROKEN PART ALSO HAD TO BE RETRIEVED, WHICH TOOK ANOTHER 70 MINUTES. ALL PARTS COULD BE REMOVED. THE EXTENSION TIME WAS EXTENDED BY OVER 2 HOURS, THE CONSEQUENCES FOR THE PATIENT ARE UNCLEAR. THE FAILURE(S) IDENTIFIED IN THE INVESTIGATION IS CONSISTENT WITH THE COMPLAINT RECORD. THE PROBABLE ROOT CAUSE COULD BE USE OF EXCESSIVE FORCE. THE PRODUCT WAS RETURNED FOR INVESTIGATION AND THE FAILURE MODE WILL BE MONITORED FOR FUTURE REOCCURRENCE.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE TIP BROKE DURING THE PROCEDURE. THE PIECE WAS RETRIEVED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE TIP BROKE DURING THE PROCEDURE. THE PIECE WAS RETRIEVED.

Description of Event or Problem · 0

IT WAS REPORTED THAT THE TIP BROKE DURING THE PROCEDURE. THE PIECE WAS RETRIEVED.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
438358 FLOWPORT II CANNULA WITH OBTURATOR STRYKER 165MM ACCESSORIES, ARTHROSCOPIC NBH STRYKER ENDOSCOPY-SAN JOSE 011393 07613252633181

Patients

Seq Age Sex Outcome Treatment
1 NA Unknown