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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. ECHELON FLEX 60 LONG; STAPLE, IMPLANTABLE

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ETHICON ENDO-SURGERY, LLC. ECHELON FLEX 60 LONG; STAPLE, IMPLANTABLE Back to Search Results
Catalog Number LONG60A
Medical Device Problem Code Failure to Fire (2610)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/29/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Date sent: 07/02/2025.D4: batch #213d27.Additional information was requested, and the following was obtained: 1.What part of the device was broken? branches or cartridge.It wasn¿t able to fire it.2.Did any piece's fall into the patient? no.3.Is the current patient status known? yes, the patient is alright.4.Was there any patient consequence or change in the post-operative care of the patient as a result of the event? no.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 determined that the long60a device was received for analysis with no apparent damage, articulated right and with a gst60d reload loaded on the device.The reload was received partially fired 1/5.The device was tested for functionality in the articulated position with the returned reload by resetting and reloading it into the device.The device achieved its complete stroke firing sequence without any difficulties.The staple line and cut line were complete and the remaining staples met the staple form release criteria.The event reported was confirmed and it is related to improper use of the device.The partially fired is consistent with an incomplete or interrupted cycle.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 #long60a, with lot/batch #c9et5w, and no non-conformances were identified.A manufacturing record evaluation was performed for the finished device batch number 213d27, and no non-conformances were identified.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 lap gastric bypass procedure, it was observed that the device could not be fired.There was no patient consequence nor surgical delay reported.No additional information provided.
 
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Brand Name
ECHELON FLEX 60 LONG
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 Key22385036
Report Number3005075853-2025-05118
Device Sequence Number12526009
Product Code GDW
UDI-Device Identifier10705036002444
UDI-Public(01)10705036002444(10)C9ET5W(17)270731
Combination Product (Y/N)N
Initial Reporter CountryEZ
PMA/510(K) Number
K081146
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) 07/02/2025
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 NumberLONG60A
Device Lot NumberC9ET5W
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer06/17/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 06/19/2025
Initial Report FDA Received Date07/02/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/02/2024
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 SexMale
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