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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. VCL+ VIO 36IN 1 S/A CT; SUTURE, ABSORBABLE, SYNTHETIC

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ETHICON INC. VCL+ VIO 36IN 1 S/A CT; SUTURE, ABSORBABLE, SYNTHETIC Back to Search Results
Catalog Number VCP359H
Device Problem Component Missing (2306)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 11/24/2023
Event Type  malfunction  
Manufacturer Narrative
Product complaint # (b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803, part 4 subpart b.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, or its employees that the report constitutes an admission that the product, ethicon, 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.H3 investigation summary: the product was returned for evaluation.Visual inspection was conducted on the returned device.Visual analysis of the returned sample revealed that was received one open box that pertain to product code vcp311h.Upon the visual inspection of the received box, it was found that contained thirty-four packets relabeled instead of thirty-six.As per product requirements, the box should contain thirty-six packages.In addition, it was noted that the tab dispenser was removed from the box.As part of our quality process, the manufacturing records of this lot-batch number were reviewed, and the manufacturing standards were met prior to the release of this batch.No conclusion could be reached on the cause of the reported event.As part of the ethicon quality process, all devices are manufactured, inspected, and released to approved specifications.A manufacturing record evaluation was performed for the finished device and no non conformances / manufacturing irregularities related to the malfunction were identified.Additional information was requested, and the following was obtained via: were there any patient consequences? no.
 
Event Description
It was reported that a patient underwent an unknown procedure on (b)(6) 2023 and suture was used.Before use on the patient, it was reported that our distributor did incoming goods checking, there was two packages of product less than expected in the box when just opened.There should be thirty-six packages of products in the box, but actually there were only thirty-four packages of products.Enclosed please find defect photo.Visual analysis of the returned sample revealed that was received one open box that pertain to product code vcp311h.Upon the visual inspection of the received box, it was found that contained thirty-four packets relabeled instead of thirty-six.As per product requirements, the box should contain thirty-six packages.In addition, it was noted that the tab dispenser was removed from the box.No additional information could be provided.No adverse patient consequences were reported.No additional information was requested.
 
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Brand Name
VCL+ VIO 36IN 1 S/A CT
Type of Device
SUTURE, ABSORBABLE, SYNTHETIC
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-SAN ANGELO
3348 pulliam st
san angelo TX 76905
Manufacturer Contact
elba bello
1000 route 202
raritan, NJ 08869
9083863534
MDR Report Key18594510
MDR Text Key333939213
Report Number2210968-2024-00695
Device Sequence Number1
Product Code GAM
UDI-Device Identifier10705031052734
UDI-Public10705031052734
Combination Product (y/n)Y
Reporter Country CodeCH
PMA/PMN Number
K132580
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign
Reporter Occupation Other
Type of Report Initial
Report Date 01/29/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received01/29/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberVCP359H
Device Lot NumberTK2AEX
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/08/2024
Date Manufacturer Received01/09/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured09/19/2023
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
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