Combined medwatch submitted to the fda on 25/aug/2023.A review of the device labeling notes the following: the current overstitch¿ endoscopic suturing system (ess) instructions for use (ifu) addressed the known and potential event of "suture cinch-deployment difficulty and suture cinch-handle broke during deployment" as follows: note: it is the collar that sets the final position of the cinch, not the plug.Caution: the safety spacer must only be removed immediately prior to deploying cinch.Troubleshooting: cinch does not cut the suture when fired: use a suitable accessory through the secondary working channel to cut the suture and remove the cinch.Warnings: only physicians possessing sufficient skill and experience in similar or the same techniques should perform endoscopic procedures.Note: it is the collar that sets the final position of the cinch, not the plug.Use standard endoscopic techniques to remove the cut suture.Additional information: the investigator determined that a device history record (dhr) review is required for this complaint, as there was three other similar complaints against this lot number, af05330 and allegation.Dhr review was completed for lot number, af05330.The subject product met all specifications and requirements in effect at the time of manufacture.Device evaluation summary: the device was returned to the apollo device analysis laboratory on 27/jul/2023.A cinch was returned with only the handle and the wire is broken at the handle.Under microscopic analysis, the wire in the handle is broken and the remaining wire was cut and removed.Due to the damaged device, a functional evaluation could not be conducted.The complaint was verified as the wire in the handle was broken which would signify that a malfunction occurred.Lab analysis was able to replicate the reported event of "suture cinch-deployment difficulty", as the wire is broken in the handle.The user effect of "suture cinch-deployment difficulty" is known and labeled possible adverse event.
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