MAUDE Adverse Event Report: ETHICON INC. PRLNE BLU 18IN 7-0 D/A BV-1; SUTURE, NONABSORBABLE, SYNTHETIC, POLYPROPYLENE

Catalog Number	8701H
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
Event or Problem Description
It was reported that a patient underwent a vascular procedure on an unknown date and suture was used.During an unknown vascular procedure, the doctor stated that he had issues with a few sutures that keep breaking at every point, the end and the swage and when he's tying his knots.Case was completed.No patient harm reported.Sterile product being returned from same lot, used sutures discarded.Did mentioned that this has happened before in other cases with the same product.Additional information was requested.
Additional Manufacturer Narrative
Product complaint (b)(4) date sent to the fda: 11/11/2024 h6 component code: g07002 - no device returned.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.A manufacturing record evaluation was performed for the finished device lot, and no non-conformances were identified.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: it was reported that ".Had issues with a few sutures that keep breaking at every point, the end and the swage and when he's tying his knots." please clarify how many sutures broke on this single procedure? please clarify how many sutures separated from the needle (detached at the swage portion of the needle) on this single procedure? please provide the source or name and title of external person providing answers to follow-up (external person submitting answers to sales rep).It was reported that.This has happened before in other cases with the same product." please confirm the number of patients affected by these issue? have any of these events been previously reported to ethicon? if so, provide the respective reference number(s).Please provide information requested below for each patient/event.What is the procedure name(s) and date(s)? can you identify the lot numbers and product code of the product that was used? what is the quantity involved per procedure? was there any alleged deficiency with the suture? could you please confirm if there was a prescription for steroids or antibiotics for the patient's recovery? if yes, please provide medication name, route and dose.Was there any medical or surgical intervention performed (product removed; re-operation; re-suturing; re-closure; drainage)? if so, please specify.What is the most current patient status? please provide the source or name and title of external person providing answers to follow-up (external person submitting answers to sales rep).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.The single complaint was reported with multiple events.There are no additional details regarding the additional events.

• Brand Name: PRLNE BLU 18IN 7-0 D/A BV-1
• Common Device Name: SUTURE, NONABSORBABLE, SYNTHETIC, POLYPROPYLENE
• 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 Key: 20653348
• Report Number: 2210968-2024-11793
• Device Sequence Number: 20887549
• Product Code: GAW
• UDI-Device Identifier: 10705031019294
• UDI-Public: (01)10705031019294(17)290430(10)100XEQ
• Combination Product (Y/N): N
• Initial Reporter State: MN
• Initial Reporter Country: US
• PMA/510(K) Number: K133356
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional,Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 11/11/2024

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 Catalogue Number: 8701H
• Device Lot Number: 100XEQ
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 10/17/2024
• Initial Report FDA Received Date: 11/11/2024
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 05/06/2024
• 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 Number: 1
• Patient Sex: Unknown