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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. ENSEAL G2 CURVED JAW 25CM; ELECTROSURGICAL CUTTING & COAGULATION & ACCESSORIES

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ETHICON ENDO-SURGERY, LLC. ENSEAL G2 CURVED JAW 25CM; ELECTROSURGICAL CUTTING & COAGULATION & ACCESSORIES Back to Search Results
Model Number NSLG2C25
Medical Device Problem Code Difficult or Delayed Activation (2577)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 09/07/2022
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Batch # x94d0w.Investigation summary: the product was returned for evaluation.Visual inspection and functional testing were conducted on the returned device.Visual analysis of the returned sample revealed that the nslg2c25 device was received with no apparent damage.The device was tested with a generator, the hand activation was not functional.However, the device worked properly with the footswitch.The instrument was disassembled to inspect the internal components and it was noted that one cable of the hand activation switch button was damaged.This caused the hand activation failure.A manufacturing record evaluation was performed for the finished device lot number, and no non-conformances were identified.As part of ethicon endo surgery¿s quality process, all devices are manufactured, inspected, and released to approved specifications.Although no conclusion could be reached on the cause of the reported event.
 
Event or Problem Description
It was reported that during an unknown procedure the customer plugged in device to gen11.The ready signed was viewed.When surgeon tried to deliver energy, nothing happened.There were no patient consequences.
 
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Brand Name
ENSEAL G2 CURVED JAW 25CM
Common Device Name
ELECTROSURGICAL CUTTING & COAGULATION & ACCESSORIES
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 Key15755213
Report Number3005075853-2022-07683
Device Sequence Number16858669
Product Code GEI
UDI-Device Identifier10705036014133
UDI-Public10705036014133
Combination Product (Y/N)N
Initial Reporter CountryUS
PMA/510(K) Number
K112033
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 11/08/2022
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
Operator of Device Health Professional
Device Model NumberNSLG2C25
Device Catalogue NumberNSLG2C25
Device Lot NumberX94L0W
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer09/20/2022
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 10/16/2022
Initial Report FDA Received Date11/08/2022
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/22/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Usage of Device Initial
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
GENERATOR
Patient SexUnknown
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