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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. SFX SPI PDS+ UNI 27IN 3-0 SA PS-1 PRM MP; SUTURE, SURGICAL, ABSORBABLE, POLYDIOXANONE

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ETHICON INC. SFX SPI PDS+ UNI 27IN 3-0 SA PS-1 PRM MP; SUTURE, SURGICAL, ABSORBABLE, POLYDIOXANONE Back to Search Results
Catalog Number SXPP1B110
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 01/19/2024
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(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.Additional information was requested, and the following was obtained: - what instruments were used to grasp the needle? na - where was the needle grasped during use? na - what was the size of the needle used? ps-1 - what tissue was being sutured when the event (needle breakage) occurred? na - was there any change in the patient¿s post-operative care due to the prolonged procedure? na - was there any additional tissue damage as a result of searching for the needle piece? na attempts are being 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.H6 component code: g07002 ¿ device not returned.
 
Event or Problem Description
It was reported that patient underwent an unknown procedure on (b)(6) 2024, and barbed suture was used.The needle broke inside the patient during closing.Operation was prolonged ten minutes, which is the time it took to find the small needle part in the patient¿s tissue.Further information was requested.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).Date sent to the fda: 4/12/2024.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.H6 component code: g07002 pending evaluation of returned device.A review of the batch manufacturing records was conducted, and no related non-conformances were identified.A device has been received, however it has not yet been evaluated.Any further information derived from the evaluation will be submitted in a supplemental 3500a form.
 
Additional Manufacturer Narrative
Product complaint #
=
> pc-(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.Additional information: h3, h6 additional h3 investigation summary the product received for analysis was identified as product code sxpp1b110.Visual inspection and metallurgical analysis were performed on the returned product.A fracture was observed at the tip of the needle.One side of the needle was received, the mating fracture surface was not provided for this evaluation.The needle was noted with marks that appears to be by surgical instrument.A scanning electron microscope (sem) was used to examine the fracture surface and surrounding area of the needle.The fracture surfaces were examined in multiple locations to determine the fracture mode.The evaluation of the sample revealed the fracture was composed of microvoid coalescence, which is evidence of a ductile fracture mode.Mechanical damage observed coincidental to the fracture provides additional evidence that the failure was induced by mechanical deformation leading to ductile overload.This was a ductile fracture.The evidence of this examination indicates that the breakage occurred at the tip of the needle during use due to tensile overload.There is no evidence of any material flaw or defect that would cause premature failure.Additional complaint information monitoring for potential safety signals is conducted through complaint trending as part of post-market surveillance.
 
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Brand Name
SFX SPI PDS+ UNI 27IN 3-0 SA PS-1 PRM MP
Common Device Name
SUTURE, SURGICAL, ABSORBABLE, POLYDIOXANONE
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-SAN LORENZO PR
road 183, km 8.3
san lorenzo PR 00754
Manufacturer Contact
elba bello
1000 route 202
raritan, NJ 08869
9083863534
MDR Report Key18856483
Report Number2210968-2024-02594
Device Sequence Number8173172
Product Code NEW
UDI-Device Identifier10705031236271
UDI-Public10705031236271
Combination Product (Y/N)Y
Initial Reporter CountryDA
PMA/510(K) Number
K150670
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
Initial Reporter Occupation Other
Type of Report Initial,Followup,Followup
Report Date (Section B) 05/13/2024
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 Expiration Date01/31/2025
Device Catalogue NumberSXPP1B110
Device Lot NumberTBBDRK
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/20/2024
Supplement Date Received by Manufacturer03/14/2024
04/19/2024
Initial Report FDA Received Date03/07/2024
Supplement Report FDA Received Date04/12/2024
05/13/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/15/2023
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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