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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 FS-2; SUTURE, ABSORBABLE, SYNTHETIC

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ETHICON INC. VCL+ UD 27IN 4-0 S/A FS-2; SUTURE, ABSORBABLE, SYNTHETIC Back to Search Results
Catalog Number VCP422H
Medical Device Problem Code Material Separation (1562)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/10/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a patient underwent a c-section procedure on (b)(6) 2025 and suture was used.At 15:30, the problem of pulling off suture needle happened during skin suturing.The integrity of the suture was checked immediately: intact.The suture was replaced and the surgery continued.There were no patient consequences reported.Additional information was requested.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).Date sent to the fda: 5/15/2025.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.A manufacturing record evaluation was performed for the finished device lot, and no non-conformances were identified.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: were there any adverse consequences associated with the patient? no.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.
 
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Brand Name
VCL+ UD 27IN 4-0 S/A FS-2
Common Device Name
SUTURE, ABSORBABLE, SYNTHETIC
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-SAN ANGELO
3348 pulliam st
san angelo TX 76905
Manufacturer Contact
orla o'mahony
1000 route 202
raritan, NJ 08869
3035526892
MDR Report Key22029592
Report Number2210968-2025-05409
Device Sequence Number20920523
Product Code GAM
UDI-Device Identifier10705031053090
UDI-Public(01)10705031053090(17)290731(10)10321A
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 Other,Foreign,Health Professional
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 05/15/2025
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 NumberVCP422H
Device Lot Number10321A
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/17/2025
Initial Report FDA Received Date05/15/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured08/26/2024
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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