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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. VCL+ UD 8X18IN 2-0 S/A CTB-1 CR; SUTURE, ABSORBABLE, SYNTHETIC

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ETHICON INC. VCL+ UD 8X18IN 2-0 S/A CTB-1 CR; SUTURE, ABSORBABLE, SYNTHETIC Back to Search Results
Catalog Number VCPB839D
Medical Device Problem Code Device Markings/Labelling Problem (2911)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/17/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that on (b)(6) 2025 the qr code could not be recognized.There was no response when customer scanning the qr code in the primary package, which could not be recognized.The product was not involved in any surgery.There is no report on patient's injury.No additional information could be provided.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).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.H6 component code: g07002 - device not returned.H6 investigation findings: c22 - photo review.A manufacturing record evaluation was performed for the finished device lot number, and no related non-conformances were identified.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.Additional information was requested, and the following was obtained: the customer feedback that they have been using dedicated 2d matric scanner.No changes on scanner.More information clarified: customer feedback is not that all packages cannot be scanned, only 1 ~ 2 packages from same box cannot be identified.The customer suspects it is due to excessive ink preprinted.Investigation summary: this is an analysis for a photo submitted to ethicon for evaluation.During the visual analysis, the following was observed: the photo shows a foil labeled as vcpb839d the qr code cannot be read by the scanner.Based on the photo review, the event describe is confirmed, however no conclusion or root cause could be determined.Hands on device analysis may provide the additional evidence necessary to confirm the root cause of the reported event.Because the device was not returned our evaluation is limited.We value the opportunity to fully analyze the device upon its return.As part of ethicon quality process all devices are manufactured, inspected, and released to approved specifications.We value your assistance in providing us an opportunity to evaluate the reported event as all information reported to our company is critical to our continuous improvement efforts.Additional complaint information monitoring for potential safety signals will be conducted through complaint trending as part of post market surveillance.
 
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Brand Name
VCL+ UD 8X18IN 2-0 S/A CTB-1 CR
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 Key21599318
Report Number2210968-2025-02681
Device Sequence Number15684712
Product Code GAM
UDI-Device Identifier10705031056602
UDI-Public(01)10705031056602(17)280430(10)TEMBQX
Combination Product (Y/N)Y
Initial Reporter CountryCH
PMA/510(K) Number
K032420
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,User Facility,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 03/13/2025
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 NumberVCPB839D
Device Lot NumberTEMBQX
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/17/2025
Initial Report FDA Received Date03/13/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/04/2023
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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