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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. PRLNE BLU 18IN 8-0 D/A BV130-5 MP; SUTURE, NONABSORBABLE, SYNTHETIC, POLYPROPYLENE

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ETHICON INC. PRLNE BLU 18IN 8-0 D/A BV130-5 MP; SUTURE, NONABSORBABLE, SYNTHETIC, POLYPROPYLENE Back to Search Results
Catalog Number W2777
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/28/2025
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a patient underwent a coronary artery bypass procedure on (b)(6) 2025 and suture was used.The doctor used suture to anastomose blood vessels during the surgery.A total of (b)(4) packs of this suture were used throughout the entire process, but 19 packs broke during the suturing process.The broken sutures have not been used again, and new sutures have been replaced.There were no patient consequences.Additional information was requested.
 
Additional Manufacturer Narrative
Product complaint #: (b)(4).Date sent to the fda: 9/10/2025.H6 component code: g07002 - device not returned.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.A manufacturing record evaluation was performed for the finished device lot, and no non-conformances were identified.Additional information was requested, the following was obtained: "breakage suture.It was reported that the suture was broken during sewing vessel in the on-pump coronary artery bypass grafting, event date is july 28th.Total 19 products occurred suture breakage issue.Involved product: 3 packages (w2777/105h0e), 7 packages (w2777/103e9z), 3 packages (w2777/102us0),1 package (w2777/sebbzc),5 packages (w2777/scbbah), the actual samples were discard, only 5 representative packages of (w2777/105h0e) will be returned.- were there patient consequences? if yes, please explain.--no - lot number scbba was not recognized.Please provide the correct lot number for product w2777.--the correct lot number is scbbah.- it was reported that the event date is (b)(6), 2025, and the alert date is (b)(6), 2025.Could you please provide a justification for this variance in the timing of the report related to this file? --loc just received the complaint from hospital in (b)(6) 2025.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.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).Date sent to the fda: 10/13/2025.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.H6 component code: g07002 no device problem found.Additional information: d9, h3, h6.H3 investigational summary: the product was returned to ethicon for evaluation.One open box with five unopened samples was received for analysis.Product code w2777.In order to evaluate the condition of the returned samples, the packets were opened, and the swage and attachment area was noted to be as expected.The sutures were dispensed without problems and examined along the strand and no issues related to breakage sutures or anomalies were observed during the evaluation.A functional test was performed using instron equipment and the tensile force was above the minimum requirements.As part of ethicon quality process, all devices are manufactured, inspected, and released to approved specifications.The event described could not be confirmed as the device performed without any difficulties noted.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.Additional complaint information monitoring for potential safety signals is conducted through complaint trending as part of post-market surveillance.
 
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Brand Name
PRLNE BLU 18IN 8-0 D/A BV130-5 MP
Common Device Name
SUTURE, NONABSORBABLE, SYNTHETIC, POLYPROPYLENE
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-SAN LORENZO PR
road 183, km 8.3
san lorenzo PR 00754
Manufacturer Contact
orla o'mahony
1000 route 202
raritan, NJ 08869
3035526892
MDR Report Key23015082
Report Number2210968-2025-10287
Device Sequence Number15908776
Product Code GAW
UDI-Device Identifier10705031126039
UDI-Public(01)10705031126039(17)291130(10)105H0E
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K133356
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
Initial Reporter Occupation Other
Type of Report Initial,Followup
Report Date (Section B) 09/10/2025
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 NumberW2777
Device Lot Number105H0E
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/12/2025
Supplement Date Received by Manufacturer09/23/2025
Initial Report FDA Received Date09/10/2025
Supplement Report FDA Received Date10/15/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/30/2024
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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