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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. PWRD ECH FLEX 60MM 34CM SHAFT; STAPLE, IMPLANTABLE

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ETHICON ENDO-SURGERY, LLC. PWRD ECH FLEX 60MM 34CM SHAFT; STAPLE, IMPLANTABLE Back to Search Results
Catalog Number PSE60A
Medical Device Problem Code Failure to Fire (2610)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/12/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Date sent: 04/18/2025.D4: batch # 602c85.Investigation summary: visual analysis of the returned sample determined that one pse60a device was returned with no apparent damage, with an ecr60b reload present and its open package.The reload was received unfired, with the reload pan partially dislodged from the right proximal side.In addition, 6 double driver missing, making the reload non-functional.The device was tested for functionality in the straight position with a test reload and achieved its complete firing sequence without any difficulties.The staple line and cut line were complete and the staples meet the staple release criteria.No conclusion could be reached on what may have caused the reload pan to dislodge.A manufacturing record evaluation was performed for the finished device batch number 602c85, and no non-conformances were identified.As part of our quality process, the manufacturing records of this batch number were reviewed, and the manufacturing standards were met prior to the release of this batch.As part of ethicon endo surgery¿s quality process, all devices are manufactured, inspected, and released to approved specifications.Additional complaint information monitoring for potential safety signals is conducted through complaint trending as part of post-market surveillance.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.
 
Event or Problem Description
It was reported that during a laparoscopic lobectomy procedure, it was observed that the device would not fire.Changed the new one to complete surgery.There was no patient consequence reported.No additional information can be provided.
 
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Brand Name
PWRD ECH FLEX 60MM 34CM SHAFT
Common Device Name
STAPLE, IMPLANTABLE
Manufacturer (Section D)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
*  00969
Manufacturer (Section G)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
*   00969
Manufacturer Contact
orla o'mahony
475 calle c
guaynabo 00969
*   00969
3035526892
MDR Report Key21866131
Report Number3005075853-2025-02769
Device Sequence Number4721652
Product Code GDW
UDI-Device Identifier10705036014324
UDI-Public(01)10705036014324(10)A9DW02(17)260730
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K110385
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 04/18/2025
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 Expiration Date07/30/2026
Device Catalogue NumberPSE60A
Device Lot NumberA9DW02
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer03/20/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 03/23/2025
Initial Report FDA Received Date04/18/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured08/31/2023
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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