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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. MCRYL VIO 36IN 3-0 S/A FS-1; SUTURE, ABSORBABLE, SYNTHETIC

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ETHICON INC. MCRYL VIO 36IN 3-0 S/A FS-1; SUTURE, ABSORBABLE, SYNTHETIC Back to Search Results
Catalog Number Y942G
Medical Device Problem Codes Break (1069); Difficult to Open or Remove Packaging Material (2922)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/29/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).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.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.Could you please confirm the quantity of products involved in this event? to date it has been reported that the device will not be returned.If the device or further details are received at a later date a supplemental medwatch will be sent.H6 component code: g07002 ¿ device not returned a review of the batch manufacturing records was conducted, and no related non-conformances were identified.Related events captured via 2210968-2023-06283, 2210968-2023-06284 and 2210968-2023-06285.
 
Event or Problem Description
It was reported that an animal underwent a canine spay procedure on (b)(6) 2023 and suture was used.The suture was difficult to remove from package.After 1st pass, it broke from where the needle meets the suture.2nd package was opened, fine to remove from package, but snapped upon placement of 1st knot.Tried again with same suture and it broke again.3rd package was opened and again it broke while trying to tie off.At this point, she had to switch to another suture to complete the surgery.Additional information was requested.
 
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Brand Name
MCRYL VIO 36IN 3-0 S/A FS-1
Common Device Name
SUTURE, ABSORBABLE, SYNTHETIC
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-JUAREZ
avenida de las torres 7125
col salvacar
ciudad juarez 32604
MX   32604
Manufacturer Contact
elba bello
1000 route 202
raritan, NJ 08869
9083863534
MDR Report Key17645896
Report Number2210968-2023-06282
Device Sequence Number12716779
Product Code GAN
UDI-Device Identifier10705031218642
UDI-Public10705031218642
Combination Product (Y/N)N
Initial Reporter CountryCA
PMA/510(K) Number
K960653
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative,Distributor
Initial Reporter Occupation Other
Type of Report Initial
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 Catalogue NumberY942G
Device Lot NumberSLMKZA
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/04/2023
Initial Report FDA Received Date08/29/2023
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured10/18/2022
Is the Device Labeled for Single Use? (Y/N) Yes
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Initial
Patient Sequence Number1
Patient SexUnknown
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