MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. ETS FLEX ARTICNG LNR CUTR 45MM; STAPLE, IMPLANTABLE

Catalog Number ATS45

Device Problems Failure to Advance (2524); Failure to Form Staple (2579); Failure to Cut (2587); Firing Problem (4011)

Patient Problem No Consequences Or Impact To Patient (2199)

Event Date 01/12/2019

Event Type  malfunction  

Manufacturer Narrative

Product complaint #: (b)(4).Batch # unk.Attempts have been made to retrieve the device.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.The manufacturing record evaluation was performed, and the manufacturing criteria was met prior to the release of this batch/lot.

Event Description

It was reported that during a pediatric lap appendectomy, three staplers: the same thing happened with each of them.They were ats45 staplers, each time they were using a tr45w.No reloads will be returned.Each time they closed down on tissue and went to fire, partial staples would deploy and nothing would cut and nothing would advance.The tech said the devices did not lock out.They were able to remove the staplers without cutting them out.Case completed with a fourth device of the same product code.There were no patient consequences reported.

Manufacturer Narrative

Product complaint(b)(4).Batch # r5ax59.Investigation summary: the analysis results found that the ats45 device was returned with no apparent damage and with no reload present on the device.The device was tested for functionality with a test reload and it fired, cut and formed the staples as intended.The device fired without any difficulties, the staple line was complete, the cut line was complete and the staples were noted to have the proper b-formed shape.The event described could not be confirmed as the device performed without any difficulties noted.There may have been other circumstances or issues that occurred during the use of the device that we were unable to duplicate during our laboratory analysis.A manufacturing record evaluation was performed for the finished device batch number, and no non-conformances were identified.

• Brand Name: ETS FLEX ARTICNG LNR CUTR 45MM
• Type of Device: STAPLE, IMPLANTABLE
• Manufacturer (Section D): ETHICON ENDO-SURGERY, LLC.; 475 calle c; guaynabo 00969
• MDR Report Key: 8314693
• MDR Text Key: 136618572
• Report Number: 3005075853-2019-16423
• Device Sequence Number: 1
• Product Code: GDW
• UDI-Device Identifier: 10705036001072
• UDI-Public: 10705036001072
• Combination Product (y/n): N
• PMA/PMN Number: K020779
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative
• Type of Report: Initial,Followup
• Report Date: 01/14/2019

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 Expiration Date: 10/22/2023
• Device Catalogue Number: ATS45
• Device Lot Number: R9532H
• Was Device Available for Evaluation?: Device Returned to Manufacturer
• Date Returned to Manufacturer: 02/07/2019
• Initial Date Manufacturer Received: 01/14/2019
• Initial Date FDA Received: 02/07/2019
• Supplement Dates Manufacturer Received: 02/07/2019
• Supplement Dates FDA Received: 03/06/2019
• Patient Sequence Number: 1
• Treatment: TR45W