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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. SFX SPI MCRYL+ UNI UD 27IN 2-0 S/A CT-1; SUTURE, SURGICAL, ABSORBABLE, POLYGLCOLIC ACID

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ETHICON INC. SFX SPI MCRYL+ UNI UD 27IN 2-0 S/A CT-1; SUTURE, SURGICAL, ABSORBABLE, POLYGLCOLIC ACID Back to Search Results
Catalog Number SXMP1B414
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/01/2024
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.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.Were there any patient consequences? 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: 2210968-2024-02685; 2210968-2024-02687; 2210968-2024-02688; 2210968-2024-02689; 2210968-2024-02690.
 
Event or Problem Description
It was reported that patient underwent an unknown procedure on an unknown date in (b)(6) 2024, and barbed suture was used.Several stratafix monocryl sutures snapped mid suture line.Sutures of different sizes, several 3-0 and 2-0 sutures.Further information has been requested.
 
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Brand Name
SFX SPI MCRYL+ UNI UD 27IN 2-0 S/A CT-1
Common Device Name
SUTURE, SURGICAL, ABSORBABLE, POLYGLCOLIC ACID
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
*   00754
Manufacturer Contact
elba bello
1000 route 202
raritan, NJ 08869
9083863534
MDR Report Key18861427
Report Number2210968-2024-02686
Device Sequence Number16972699
Product Code GAM
UDI-Device Identifier10705031236400
UDI-Public10705031236400
Combination Product (Y/N)Y
Initial Reporter CountryCA
PMA/510(K) Number
N12159
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
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 Date06/30/2025
Device Catalogue NumberSXMP1B414
Device Lot NumberTHBHPS
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/20/2024
Initial Report FDA Received Date03/07/2024
Was Device Evaluated by Manufacturer? (Y/N) Device Not Returned to Manufacturer
Date Device Manufactured07/29/2023
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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