MAUDE Adverse Event Report: ETHICON INC. LAPRA-TY ABSORBABLE X6::SUTURE CLIP; CLIP, IMPLANTABLE

Catalog Number XC200

Device Problem Positioning Failure (1158)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Date 11/06/2023

Event Type  malfunction  

Manufacturer Narrative

Product complaint # : (b)(4).H6 component code: g07002 - device not returned.This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by ethicon inc, or its employees that the report constitutes an admission that the product, ethicon inc or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.To date the device has not been returned.If the device or further details are received at a later date a supplemental medwatch will be sent.Attempts are being made to obtain the following information.To date no response has been provided.If further details are received at a later date a supplemental medwatch will be sent.What is the total number of clips with issues when it was attempted to load the clip on the suture during this surgery reported? please confirm the quantity since 21 products are reported to be involved package lot number of the clips? please provide the applier product code and lot number? please confirm if there is an issue with the applier? if yes, please create a product complaint and provide the respective reference number(s).When the event occurred, was the suture placed near the hinge of the clip? were you able to lock the clip closed on the suture? if yes, after it closed, was the clip holding securely fixed on the suture? was the applier checked for damaged (jaws straight and aligned)? if the clip did not close/hold on the suture, was the clip used in an application where the suture was under tension? please provide the source or name of person providing answers to follow-up questions: events reported via: 2210968-2023-09426.

Event Description

It was reported that a patient underwent an unknown on (b)(6) 2023 and suture clips were used.During the procedure, it was reported to the sales rep that on the pack table the tech was attempting to load the clip on the suture (2.0 vicryl) that the clips appear to be partially dissolved and they are soft and not clipping but just go flat.They have gone through two or three packs of clips with about half of them being defective.Procedure was ongoing so the resolution is unclear at this time.There were no adverse consequences reported.Unknown quantity of samples will be returned.No adverse patient consequences were reported.Additional information was requested.

• Brand Name: LAPRA-TY ABSORBABLE X6::SUTURE CLIP
• Type of Device: CLIP, IMPLANTABLE
• Manufacturer (Section D): ETHICON INC.; 1000 route 202; raritan NJ 08869
• Manufacturer (Section G): ETHICON INC.
• Manufacturer Contact: elba bello ; 1000 route 202; raritan, NJ 08869 ; 9083863534
• MDR Report Key: 18263978
• MDR Text Key: 330017806
• Report Number: 2210968-2023-09425
• Device Sequence Number: 1
• Product Code: FZP
• UDI-Device Identifier: 10705031206885
• UDI-Public: 10705031206885
• Combination Product (y/n): N
• Reporter Country Code: US
• PMA/PMN Number: K931492
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: Health Professional
• Reporter Occupation: Other
• Type of Report: Initial
• Report Date: 12/04/2023

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Catalogue Number: XC200
• Was Device Available for Evaluation?: No
• Initial Date Manufacturer Received: 11/06/2023
• Initial Date FDA Received: 12/04/2023
• Was Device Evaluated by Manufacturer?: Device Not Returned to Manufacturer
• Is the Device Single Use?: Yes
• Is This a Reprocessed and Reused Single-Use Device?: No
• Type of Device Usage: Initial
• Patient Sequence Number: 1