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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. PWRD ECH FLEX 60MM 34CM SHAFT; STAPLE, IMPLANTABLE

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ETHICON ENDO-SURGERY, LLC. PWRD ECH FLEX 60MM 34CM SHAFT; STAPLE, IMPLANTABLE Back to Search Results
Catalog Number PSE60A
Medical Device Problem Code Failure to Fire (2610)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 08/01/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Date sent: 08/28/2025.D4: batch #769c50.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 one pse60a device was returned with the anvil bent upwards and with an gst60b reload present.The reload was received partially fired 1/16.Furthermore, the anvil knife slot was noted to be damaged.No functional test was performed due to the condition of the device.It is possible that the combination of tissue and/or buttressing material compressed between the device jaws may have been beyond indicated thickness or tissue that cannot compress to the indicated range for the selected reload.This may have caused excessive force to be applied to the underside of the solid steel anvil leading to this damage.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 pse60a with lot number c9dd4e; and no non-conformances were identified.A manufacturing record evaluation was performed for the finished device batch number 769c50, 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 an unknown procedure, it was observed that the device could not be fired.Changed to a new one to complete the procedure.There was no patient consequence nor surgical delay reported.No additional information provided.
 
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Brand Name
PWRD ECH FLEX 60MM 34CM SHAFT
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 Key22912712
Report Number3005075853-2025-06869
Device Sequence Number13039250
Product Code GDW
UDI-Device Identifier10705036014324
UDI-Public(01)10705036014324(10)C9DD4E(17)261231
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K110385
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) 08/28/2025
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 NumberPSE60A
Device Lot NumberC9DD4E
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer08/13/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/15/2025
Initial Report FDA Received Date08/28/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured01/27/2024
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
Concomitant Medical Products
and Therapy/Usage Dates
GST60B
Patient SexUnknown
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