MAUDE Adverse Event Report: TELEFLEX MEDICAL WECKSTAT STAPLE EXTRACTOR 12/BOX; STAPLE, REMOVABLE (SKIN)

Catalog Number	525980
Medical Device Problem Code	Difficult to Open or Close (2921)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	11/26/2024
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Qn#(b)(4).Complaint verification testing could not be performed as no sample was returned for analysis.A device history record review was performed and no relevant findings were identified.Without the device to evaluate the complaint could not be confirmed and the probable cause could not be determined from the available information.Teleflex will continue to monitor and trend for reports of this nature.Other remarks: n/a.Corrected data: n/a.
Event or Problem Description
It was reported that " after squeezing the handle and the trigger to remove the staple, the handle did not open during a surgery.Therefore, another unit was used to complete the procedure.There was a small amount of bleeding when removing the staple from the skin, but the patient recovered after that." no patient harm or injury.The patient status is reported as "fine".
Event or Problem Description
It was reported that " after squeezing the handle and the trigger to remove the staple, the handle did not open during a surgery.Therefore, another unit was used to complete the procedure.There was a small amount of bleeding when removing the staple from the skin, but the patient recovered after that.".No patient harm or injury.The patient status is reported as "fine".
Additional Manufacturer Narrative
Qn#(b)(4).The customer returned one unit of 525980 weckstat staple extractor 12/box.The sample was visually examined with and without magnification.Visual examination of the returned sample revealed no clear evidence of use in the form of biological material.No defects or anomalies were observed on the returned sample.Functional inspection was performed by attempting to remove staples that were fired onto a simulated skin pad.All 39 staples tested were successfully removed from the simulated skin pad with no difficulty.No functional issues were found with the returned sample.The reported complaint of "failure to function-not removing staples" could not be confirmed based upon the sample received.The returned staple extractor was able to successfully remove all tested staples from the simulated skin pad with no difficulty.Visual and functional inspection did not reveal looseness in the jaws.A device history record review was performed on the device with no evidence to suggest a manufacturing related cause.There were no functional issues found with the returned staple extractor.Teleflex will continue to monitor and trend on complaints of this nature.

• Brand Name: WECKSTAT STAPLE EXTRACTOR 12/BOX
• Common Device Name: STAPLE, REMOVABLE (SKIN)
• Manufacturer (Section D): TELEFLEX MEDICAL; morrisville NC
• Manufacturer (Section G): TELEFLEX MEDICAL; rancho el descanso; tecate 21478 ; MX 21478
• Manufacturer Contact: mariah mackinnon ; 3015 carrington mill blvd; morrisville, NC 27560
• MDR Report Key: 20968626
• Report Number: 3003898360-2024-01527
• Device Sequence Number: 11770416
• Product Code: QQS
• UDI-Device Identifier: 14026704631763
• UDI-Public: (01)14026704631763(11)240212(17)290211(10)73B2400350(21)
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Foreign,Distributor
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 11/26/2024

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: 525980
• Device Lot Number: 73B2400350
• 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: 11/26/2024
• Supplement Date Received by Manufacturer: 01/08/2025
• Initial Report FDA Received Date: 12/18/2024
• Supplement Report FDA Received Date: 01/14/2025
• Was Device Evaluated by Manufacturer? (Y/N): Yes
• Date Device Manufactured: 02/12/2024
• 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