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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. SFXSPI MCL+ UNI UD 24IN 3-0 SA PS-2 PR; SUTURE, ABSORBABLE, SYNTHETIC, POLYGLYCOLIC ACID

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ETHICON INC. SFXSPI MCL+ UNI UD 24IN 3-0 SA PS-2 PR; SUTURE, ABSORBABLE, SYNTHETIC, POLYGLYCOLIC ACID Back to Search Results
Catalog Number SXMP1B108
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 08/29/2025
Type of Reportable Event Serious Injury
Event or Problem Description
It was reported that a patient underwent a procedure for plate removal and scar reversion from a left proximal humerus fracture surgery on (b)(6) 2025 and a barbed suture was used.During the procedure, at the time of closing the incision, the physician assistant (pa) noticed that the tip of the needle was missing.From x-ray, the radiologist saw a 1.3mm tip of the needle in the lateral soft tissue of the proximal arm.The patient had to return to the operating room to get the needle tip removed.No further information was provided.
 
Additional Manufacturer Narrative
Product complaint #(b)(4).This is a combination product, and the event has been reviewed for both the suture and the triclosan.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.D4: udi: as the lot number for the device involved in the event was not provided, the full udi is currently not available.As no contact information has been provided, no follow up can or will be performed at this time.Should further details be provided, a supplemental medwatch will be sent.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.This medwatch report is in response to receipt of user facility medwatch form mw5175695,.
 
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Brand Name
SFXSPI MCL+ UNI UD 24IN 3-0 SA PS-2 PR
Common Device Name
SUTURE, ABSORBABLE, SYNTHETIC, POLYGLYCOLIC ACID
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
*   00754
Manufacturer Contact
orla o'mahony
1000 route 202
raritan, NJ 08869
3035526892
MDR Report Key23346932
Report Number2210968-2025-12067
Device Sequence Number12751914
Product Code GAM
UDI-Device Identifier10705031236646
UDI-Public10705031236646
Combination Product (Y/N)Y
Initial Reporter CountryUS
PMA/510(K) Number
N12159
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Health Professional,User Facility
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 10/21/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? Yes
Operator of Device Health Professional
Device Catalogue NumberSXMP1B108
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/07/2025
Initial Report FDA Received Date10/21/2025
Was Device Evaluated by Manufacturer? (Y/N) No
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
Outcome Attributed to Adverse Event Required Intervention;
Patient Age53 YR
Patient SexFemale
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