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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: DAVOL INC., SUB. C.R. BARD, INC. -1213643 OPTIFIX STRAIGHT; STAPLE, IMPLANTABLE

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DAVOL INC., SUB. C.R. BARD, INC. -1213643 OPTIFIX STRAIGHT; STAPLE, IMPLANTABLE Back to Search Results
Catalog Number 0113126
Medical Device Problem Code Mechanical Jam (2983)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 10/08/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
As reported the optifix straight fixation device failed to fire.Evaluation of the sample finds for bent guide wire and backup tabs.The components are found to be bent from applied forces while in use.The barrel insert detached because of the bent guide wire pushing against the barrel insert during actuation while in use forcing it free from the cannula crimps from the firing force.No manufacturing anomies were found.A review of the manufacturing records was performed and found the lot was manufactured to specification.The instructions-for-use (ifu) supplied with the device adequately describe the proper technique for successful fastener delivery.The precautions section of ifu states "care should be taken not to use excessive counterpressure as this may damage the distal tip of the device as well as the mesh and/or tissue" note: section a through f - the information provided by bd represents all of the known information at this time.Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bd.
 
Event or Problem Description
As reported, an inguinal hernia procedure was performed on (b)(6) 2025.During this procedure, the optifix straight fixation device failed to fire.It was reported that the device got stuck when firing.When the device was checked with dry firing, it was found to be still jammed.The procedure was completed using a spare sorbafix fixation device.There was no patient injury.
 
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Brand Name
OPTIFIX STRAIGHT
Common Device Name
STAPLE, IMPLANTABLE
Manufacturer (Section D)
DAVOL INC., SUB. C.R. BARD, INC. -1213643
100 crossings blvd.
warwick RI 02886
Manufacturer (Section G)
BARD SHANNON LIMITED -3005636544
san geronimo industrial park
lot #1, road #3, km 79.7
humacao PR 00791
Manufacturer Contact
andrew topoulos
100 crossings blvd.
warwick, RI 02886
8005566756
MDR Report Key23425734
Report Number1213643-2025-01041
Device Sequence Number18192210
Product Code GDW
UDI-Device Identifier00801741074318
UDI-Public(01)00801741074318(17)260828(10)HUJV1787
Combination Product (Y/N)N
Initial Reporter CountryMX
PMA/510(K) Number
K142873
Number of Events Summarized1
Summary Report (Y/N)N
Reporter Type Manufacturer
Report Source Other,Health Professional,User Facility,Distributor
Initial Reporter Occupation Physician
Type of Report Initial
Report Date (Section B) 10/29/2025
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 Expiration Date08/28/2026
Device Catalogue Number0113126
Device Lot NumberHUJV1787
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer10/27/2025
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 10/27/2025
Initial Report FDA Received Date10/30/2025
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/27/2024
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
Outcome Attributed to Adverse Event Other;
Patient SexUnknown
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