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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. HARMONIC SCALPEL HAND PIECE; INSTRUMENT, ULTRASONIC SURGICAL

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ETHICON ENDO-SURGERY, LLC. HARMONIC SCALPEL HAND PIECE; INSTRUMENT, ULTRASONIC SURGICAL Back to Search Results
Catalog Number HP054
Medical Device Problem Code Failure to Read Input Signal (1581)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/01/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Date sent: 5/21/2025.D4 batch #: t9565a.Investigation summary: the product was returned for evaluation.Visual inspection and functional testing were conducted on the returned device.Visual analysis of the returned sample revealed that the device was received with no apparent damage.It was connected to a generator, evaluated with a test instrument, and was found to be functional.The handpiece was disassembled to verify the condition of the internal components,.The moisture indicator was positive.The handpiece has a number of seals to prevent fluids from entering the housing."positive moisture indicator¿ describes a condition where water enters the handpiece cavity during the steam sterilization process.The primary path of ingress is the distal seal, this may be caused by a reduction of the compressive force on the distal seal.However, no definitive root cause could be drawn.A manufacturing record evaluation was performed for the finished device batch number, and no non-conformances were identified.As part of the quality process all devices are manufactured, inspected, and released to approved specifications.Although no conclusion could be reach on the cause of the reported event.It is probable that the ingress of moisture affected handpiece functionality.
 
Event or Problem Description
It was reported that during an unknown procedure the handpiece has 24 remaining inserts, continuously delivers error messages.No patient outcome.
 
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Brand Name
HARMONIC SCALPEL HAND PIECE
Common Device Name
INSTRUMENT, ULTRASONIC SURGICAL
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 
*  
3035526892
MDR Report Key22062585
Report Number3005075853-2025-03795
Device Sequence Number7638999
Product Code LFL
UDI-Device Identifier20705036002144
UDI-Public(01)20705036002144
Combination Product (Y/N)N
Initial Reporter CountryAU
PMA/510(K) Number
K002906
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) 05/21/2025
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 NumberHP054
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/23/2025
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 05/18/2025
Initial Report FDA Received Date05/21/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/11/2020
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Concomitant Medical Products
and Therapy/Usage Dates
GENERATOR.
Patient SexUnknown
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