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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. PDS PLUS SUTURE 30"(75CM) 5-0 VIO; SUTURE, SURGICAL, ABSORBABLE

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ETHICON INC. PDS PLUS SUTURE 30"(75CM) 5-0 VIO; SUTURE, SURGICAL, ABSORBABLE Back to Search Results
Catalog Number PDP148H
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 06/30/2025
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, 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.Additional information was requested and the following response was provided: ¿ did this issue contribute to any patient adverse event? --please refer to the event description, other information requested is unknown.¿ please perform and document the follow up attempt for product return.--no device can be returned currently.To date it has been reported that the device will not be 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 a superficial tumor resection surgery on (b)(6) 2025 and suture was used.During the surgical procedure, the suture broke on its own, affecting the surgical progress.The suture was replaced and sutured again.There were no adverse patient consequences reported.Additional information was requested.
 
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Brand Name
PDS PLUS SUTURE 30"(75CM) 5-0 VIO
Common Device Name
SUTURE, SURGICAL, ABSORBABLE
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-JUAREZ
calle durango #2751
ciudad juarez 32575
MX   32575
Manufacturer Contact
orla o'mahony
1000 route 202
raritan, NJ 08869
3035526892
MDR Report Key22833668
Report Number2210968-2025-09452
Device Sequence Number15817217
Product Code NEW
UDI-Device Identifier10705031047921
UDI-Public(01)10705031047921(17)290930(10)1049KT
Combination Product (Y/N)Y
Initial Reporter CountryCH
PMA/510(K) Number
K061037
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,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
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 NumberPDP148H
Device Lot Number1049KT
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/22/2025
Initial Report FDA Received Date08/18/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured10/24/2024
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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