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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. EB EXC GRN 4X30IN 2 S/A V-37; SUTURE, NONABSORBABLE, SYNTHETIC, POLYETHYLENE

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ETHICON INC. EB EXC GRN 4X30IN 2 S/A V-37; SUTURE, NONABSORBABLE, SYNTHETIC, POLYETHYLENE Back to Search Results
Catalog Number MX69G
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/07/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product complaint #(b)(4).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.H6 component code: g07002 device not returned a manufacturing record evaluation was performed for the finished device lot number, and no related non-conformances were identified.Attempts have been made to retrieve the device.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.
 
Event or Problem Description
It was reported that a patient underwent a total knee surgery on (b)(6)2025 and suture was used.The needle broke about one third from the point.Case was completed with a like device.Needle was retrieved.An x-ray was performed and found the needle tip in the suction machine.No patient harm was reported.No additional information was provided.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).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.Additional h3 investigation summary: a failed suture needle was submitted for fractographic evaluation.The component was identified as product code mx69g.It was requested to assess the fracture mode of the failure.The product received for analysis was mx69g.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.Visual inspection and metallurgical analysis were performed on the returned product.A fracture was observed in the body of the needle.A scanning electron microscope (sem) was used to examine the fracture surfaces and surrounding area of the needle.The fracture surfaces were examined in multiple locations to determine the fracture mode.The evaluation revealed the fracture was predominantly composed of microvoid coalescence, which is evidence of a ductile fracture mode.Transgranular cleavage was also identified in small areas across the fracture surface.Mechanical damage and a cup-and-cone shaped fracture provide additional evidence that the failure was induced by mechanical deformation leading to ductile overload.This was a ductile fracture.The evidence of this examination indicates that the breakage occurred from mechanical deformation, indents and scratches, due to gripping, bending and overstressing of the needle.There is no evidence of any material flaw that would cause premature failure.Additional complaint information monitoring for potential safety signals is conducted through complaint trending as part of post-market surveillance.
 
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Brand Name
EB EXC GRN 4X30IN 2 S/A V-37
Common Device Name
SUTURE, NONABSORBABLE, SYNTHETIC, POLYETHYLENE
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.
Manufacturer Contact
elba bello
1000 route 202
raritan, NJ 08869
9083863534
MDR Report Key21256916
Report Number2210968-2025-01021
Device Sequence Number15505479
Product Code GAT
UDI-Device Identifier10705031047150
UDI-Public(01)10705031047150(17)290930(10)104BDE
Combination Product (Y/N)N
Initial Reporter StateOH
Initial Reporter CountryUS
PMA/510(K) Number
K946173
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 02/21/2025
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 NumberMX69G
Device Lot Number104BDE
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 01/08/2025
Supplement Date Received by Manufacturer01/24/2025
Initial Report FDA Received Date01/28/2025
Supplement Report FDA Received Date02/21/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/28/2024
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 Number1
Patient SexUnknown
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