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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. PRLNE BLU 30IN 2-0 D/A ST-70; SUTURE, NONABSORBABLE, SYNTHETIC, POLYPROPYLENE

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ETHICON INC. PRLNE BLU 30IN 2-0 D/A ST-70; SUTURE, NONABSORBABLE, SYNTHETIC, POLYPROPYLENE Back to Search Results
Catalog Number W8400
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/08/2025
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.Attempts are being 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.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.
 
Event or Problem Description
It was reported that a patient underwent an unknown procedure on (b)(6) 2025 and suture was used.The suture was broken when the surgeon attempted to sew the tissue.Changed to another one to complete the surgery.There were no adverse patient consequences reported.No additional information could be provided.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).Date sent to the fda: 6/10/2025.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.H6 component code: g07002 no device problem found.Additional information: d9, h3, h6.H3 investigational summary: the product was returned to ethicon for evaluation.One empty overwrap and one strand in two sections around a folder were received for analysis.Product code w8400.The product code is double armed.During the visual inspection of the needles, the swage and attachment area were noted to be as expected.The received suture pieces were inspected, and no breakage suture was observed.Even though the extremes were noted to be cut probably caused by a surgical instrument.The functional test was performed using instron equipment and the tensile force was above the minimum requirements.The condition of the sample received indicates improper handling of the device.As with any device, care should be taken to avoid damage to the strand when handling.It should be noted that as part of our quality process, the device is visually inspected and functionally tested during manufacturing to ensure the device meets the required specifications prior to shipment.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
PRLNE BLU 30IN 2-0 D/A ST-70
Common Device Name
SUTURE, NONABSORBABLE, SYNTHETIC, POLYPROPYLENE
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-SAN LORENZO PR
road 183, km 8.3
san lorenzo PR 00754
Manufacturer Contact
orla o'mahony
1000 route 202
raritan, NJ 08869
3035526892
MDR Report Key21978292
Report Number2210968-2025-05027
Device Sequence Number7265434
Product Code GAW
UDI-Device Identifier10705031128019
UDI-Public(01)10705031128019(17)290131(10)UBBBZA
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K133356
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
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 NumberW8400
Device Lot NumberUBBBZA
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 04/08/2025
Supplement Date Received by Manufacturer05/13/2025
Initial Report FDA Received Date05/07/2025
Supplement Report FDA Received Date06/10/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured02/08/2024
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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