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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. PDSII VIO 27IN 0 S/A CT-1; SUTURE, SURGICAL, ABSORBABLE

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ETHICON INC. PDSII VIO 27IN 0 S/A CT-1; SUTURE, SURGICAL, ABSORBABLE Back to Search Results
Catalog Number Z340H
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/20/2023
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product complaint # (b)(4).Additional information: d9, h6 component code: g07002 - device not evaluated.Additional information has been requested and received.Attempts to obtain the device have been made.If further details are received at a later date a supplemental medwatch will be sent.Please confirm the number of sutures that broke during this procedure.The suture breakage has occurred (b)(4) times while doing surgery.When did the suture break (in the package, during removal from the package, during handling before use on patient or during use on the patient)? please specify the suture was inserted and when trying to close it broke.The second time it occurred i called the company that we had purchased the suture from, covetrus.Lot # qgmcss.A review of the batch manufacturing records was conducted, and no related non-conformances were identified.Note: events reported on mw# 2210968-2024-00458, mw# 2210968-2024-02951, mw# 2210968-2024-02952.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, 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.
 
Event or Problem Description
It was reported an animal underwent an unknown procedure on (b)(6) 2023 and suture was used.Suture is breaking under regular tension.¿ additional information has been requested.
 
Additional Manufacturer Narrative
Product complaint # (b)(4) date sent to the fda: 3/21/2024 additional information: d9, h3, h6 h3 investigational summary: according to the information received, it was reported that the suture is breaking under regular tension.The product was returned to ethicon for evaluation.Visual inspection and functional testing were conducted on the returned device.The returned sample revealed that it was received one winding former with a suture that pertained to product code z340h.During visual inspection of the returned sample, it was observed that the strand had begun with a degradation process caused by exposure to the environment, which caused the sutures to be broken.The foil packets were not returned for evaluation to determine the assignable cause.As part of our quality process, the manufacturing records of this lot-serial number were reviewed, and the manufacturing standards were met prior to the release of this batch.No conclusion could be reached as to what caused the reported complaint.As part of the ethicon quality process, all devices are manufactured, inspected, and released to approved specifications.Additional complaint information monitoring for potential safety signals will be conducted through complaint trending as part of post-market surveillance.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.
 
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Brand Name
PDSII VIO 27IN 0 S/A CT-1
Common Device Name
SUTURE, SURGICAL, ABSORBABLE
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-JUAREZ
calle durango #2751
ciudad juarez 32575
MX   32575
Manufacturer Contact
elba bello
1000 route 202
raritan, NJ 08869
9083863534
MDR Report Key18890555
Report Number2210968-2024-02950
Device Sequence Number11499788
Product Code NEW
UDI-Device Identifier10705031060623
UDI-Public10705031060623
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
N18331
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,Distributor
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 03/21/2024
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 Date05/31/2025
Device Catalogue NumberZ340H
Device Lot NumberQGMCSS
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/08/2024
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/27/2024
Supplement Date Received by Manufacturer03/08/2024
Initial Report FDA Received Date03/12/2024
Supplement Report FDA Received Date03/21/2024
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/09/2020
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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