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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. CIRCULAR MECH XL SEAL 29MM; STAPLE, IMPLANTABLE

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ETHICON ENDO-SURGERY, LLC. CIRCULAR MECH XL SEAL 29MM; STAPLE, IMPLANTABLE Back to Search Results
Catalog Number ECS29B
Medical Device Problem Code Failure to Cut (2587)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/10/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during an unknown procedure the device did not cut.No patient consequences reported when this complaint event occurred.
 
Additional Manufacturer Narrative
(b)(4).Date sent 6/24/2025.D4 batch # unk.Attempts have been 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.The manufacturing records were reviewed and the manufacturing/packaging criteria were met prior to the release of this lot.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.
 
Additional Manufacturer Narrative
(b)(4).Date sent 10/1/2025.The device upon which this medwatch is based has been received, however, the evaluation is not yet complete.Any further information derived from the evaluation will be submitted in a supplemental 3500a form.
 
Additional Manufacturer Narrative
(b)(4).Date sent 10/7/2025.D4.Batch #781c84.Investigation summary: the product was returned for thorough evaluation, which included visual inspections and functional testing of the returned device.Visual analysis of the returned sample revealed that the ecs29b device arrived with no apparent damage.Only the anvil half washer was present and there was no staples present, indicating that the device achieved a full firing stroke.The device was reloaded with staples, a new washer was placed on the device and it was tested for functionality.It fired and formed all the staples as well as completely cut the test media and the breakaway washer without incident.The staple line was complete, and the staples meet the staple form release criteria.The event described could not be confirmed as the device cut as expected and it was returned without detectable damage.Although no product defect was identified, there may have been other circumstances or issues that occurred during the use of the device that could not be replicated during the laboratory analysis.As part of ethicon endo surgery¿s quality process, all devices are manufactured, inspected, and released to approved specifications.A manufacturing record evaluation was performed for the finished device batch number 781c84, and no non-conformances were identified.
 
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Brand Name
CIRCULAR MECH XL SEAL 29MM
Common Device Name
STAPLE, IMPLANTABLE
Manufacturer (Section D)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
Manufacturer (Section G)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
Manufacturer Contact
orla o'mahony
475 calle c
guaynabo 
3035526892
MDR Report Key22318448
Report Number3005075853-2025-04685
Device Sequence Number8812307
Product Code GDW
UDI-Device Identifier10705036022930
UDI-Public(01)10705036022930(17)281231(10)C9DA2A
Combination Product (Y/N)N
Initial Reporter CountryKS
PMA/510(K) Number
K983536
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,Followup,Followup
Report Date (Section B) 10/07/2025
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 NumberECS29B
Device Lot NumberC9DA2A
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Follow-Up
Initial Date Received by Manufacturer 06/15/2025
Supplement Date Received by Manufacturer09/25/2025
09/25/2025
Initial Report FDA Received Date06/24/2025
Supplement Report FDA Received Date10/01/2025
10/07/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/23/2024
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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