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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. LIGAMAX-5MM ENDO CLIP APPLIER; CLIP, IMPLANTABLE

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ETHICON ENDO-SURGERY, LLC. LIGAMAX-5MM ENDO CLIP APPLIER; CLIP, IMPLANTABLE Back to Search Results
Catalog Number EL5ML
Device Problems Failure to Form Staple (2579); Mechanical Jam (2983)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/31/2024
Event Type  malfunction  
Manufacturer Narrative
(b)(4).Date sent: 2/22/2024.D4: batch # a9dv61.Investigation summary: the product was returned to ethicon for evaluation.Visual inspection and functional testing were conducted on the returned device.Visual analysis of the returned sample revealed that the el5ml device was returned with no apparent damage.In an attempt to replicate the reported incident, the instrument was tested for functionality.During the analysis, the device was cycled and it fed and formed one(1) conforming clip. upon testing, the jaws open and close without any difficulties.In addition, the device locked out as intended.Although no conclusion could be reached on the cause of the reported event, the instructions for use do contain the following caution: do not excessively twist or torque the instrument jaws when positioning or firing the instrument on a tubular structure or vessel.Excessive twisting or torquing may result in clip malformation.Do not insert the clip applier through a trocar if a clip is present in the jaws.This may result in clip malformation, dislodged clips, or damage to the instrument.If a clip is present in the jaws, fully squeeze the trigger against the handle, then fully release the trigger to release the clip from the jaws before inserting the device through the trocar.The event described could not be confirmed as the device performed without any difficulties noted.A manufacturing record evaluation was performed for the finished device batch and lot number, and no non-conformances were identified.
 
Event Description
It was reported that during an unknown surgery for liver, a clip was not fed into the jaws after the several firings.Outside the body, the surgeon took the clip out and found it bent in a strange direction.Another device was used to complete the case.There were no adverse consequences to the patient.No further information is available.
 
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Brand Name
LIGAMAX-5MM ENDO CLIP APPLIER
Type of Device
CLIP, IMPLANTABLE
Manufacturer (Section D)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
*  00969
Manufacturer (Section G)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
*   00969
Manufacturer Contact
kate karberg
475 calle c
guaynabo 
*  
3035526892
MDR Report Key18762690
MDR Text Key336319961
Report Number3005075853-2024-01557
Device Sequence Number1
Product Code FZP
Combination Product (y/n)N
Reporter Country CodeJA
PMA/PMN Number
K050344
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Foreign,Health Professional
Reporter Occupation Other
Type of Report Initial
Report Date 02/22/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/22/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberEL5ML
Device Lot NumberA9DV61
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/19/2024
Date Manufacturer Received01/31/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured09/15/2023
Is the Device Single Use? Yes
Type of Device Usage Initial
Patient Sequence Number1
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