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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. STLESS STEEL SIL 4X18IN 5 S/A V-40; SUTURE, NONABSORBABLE, STEEL

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ETHICON INC. STLESS STEEL SIL 4X18IN 5 S/A V-40; SUTURE, NONABSORBABLE, STEEL Back to Search Results
Catalog Number M650G
Medical Device Problem Code Material Separation (1562)
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 a patient underwent a patient underwent an unknown procedure on (b)(6) 2025 and a suture was used.When using the suture, the needle was not used and the problem of pulling off suture needle happened.The doctor immediately replaced it.Additional information has been requested.
 
Additional Manufacturer Narrative
Product complaint # (b)(4) additional information: h6 component code: g07002 - device not returned.Additional information has been requested however not received.Attempts to obtain the device have been made.If further details are received at a later date a supplemental medwatch will be sent.Did this issue contribute to any patient adverse event? received information as following from sales rep via phone today.Please refer to the event description, other information requested is unknown.A manufacturing record evaluation was performed for the finished device lot number, and no related non-conformances were identified.No product is available for return.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.
 
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Brand Name
STLESS STEEL SIL 4X18IN 5 S/A V-40
Common Device Name
SUTURE, NONABSORBABLE, STEEL
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 00754
*   00754
Manufacturer Contact
orla o'mahony
1000 route 202
raritan, NJ 08869
3035526892
MDR Report Key23040007
Report Number2210968-2025-10446
Device Sequence Number9477152
Product Code GAQ
UDI-Device Identifier10705031045439
UDI-Public(01)10705031045439(17)280630(10)THBBJZ
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K946173
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Foreign
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 09/12/2025
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 NumberM650G
Device Lot NumberTHBBJZ
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 08/15/2025
Initial Report FDA Received Date09/12/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured07/13/2023
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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