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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. VCL+ UD 27IN 4-0 S/A RB-1; SUTURE, ABSORBABLE, SYNTHETIC

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ETHICON INC. VCL+ UD 27IN 4-0 S/A RB-1; SUTURE, ABSORBABLE, SYNTHETIC Back to Search Results
Catalog Number VCP214H
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product complaint # (b)(4).H6 component code: g07002 - device not returned.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.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.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.How many procedures were affected by this issue? how many devices demonstrated the alleged deficiency on each involved patient event? did the needles break during use or upon handling? or were found broken in the package? please provide the source or name and title of the external person providing answers to follow-up (external person submitting answers to sales rep).D4: udi: the manufacture and expiration dates are currently not available.Therefore, the full udi is currently not available.
 
Event or Problem Description
It was reported an animal underwent an unknown veterinary procedure on an unknown date and suture was used.During the procedure, it was reported by the healthcare professional, that they had an issue with one of the products.Their veterinarians have had many suture packs from this latest box that the needle has broken during procedures, which normally doesn't happen at all.Unknown if the device was available for return.No adverse patient consequences were reported.Additional information was requested.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).A manufacturing record evaluation was performed for the finished device lot, and no non-conformances were identified.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.
 
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Brand Name
VCL+ UD 27IN 4-0 S/A RB-1
Common Device Name
SUTURE, ABSORBABLE, SYNTHETIC
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 Key21047852
Report Number2210968-2024-14171
Device Sequence Number20953420
Product Code GAM
UDI-Device Identifier10705031051669
UDI-Public10705031051669
Combination Product (Y/N)Y
Initial Reporter CountryCA
PMA/510(K) Number
K132580
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
Report Date (Section B) 02/14/2025
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 NumberVCP214H
Device Lot NumberTCMCAR
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/04/2024
Supplement Date Received by Manufacturer01/19/2025
Initial Report FDA Received Date12/31/2024
Supplement Report FDA Received Date02/14/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured03/06/2023
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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