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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN SURGICAL GIA; STAPLER, SURGICAL

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COVIDIEN SURGICAL GIA; STAPLER, SURGICAL Back to Search Results
Model Number GIA80MTC
Medical Device Problem Code Failure to Fire (2610)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/19/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
According to the reporter, during a right hemicolectomy, the device did not fire from the start.A new device was used to resolve the issue.There was no patient injury.
 
Additional Manufacturer Narrative
Additional information: b5, g3 medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
According to the reporter, during a right hemicolectomy, the device did not fire from the start.A new reload with the same handle was used to resolve the issue.There was no patient injury.
 
Additional Manufacturer Narrative
Additional information: d9, g3, h3, h6 h3 evaluation summary: medtronic conducted an investigation based upon all information received.The device and a photo were available for evaluation.Func tional testing found that the instrument and sulu were applied to test media with acceptable results.The knife cut completely and cleanly.The firing knob could be advanced and retracted without any hang-ups.It was reported that the device did not fire.The reported issue was confirmed.The product analysis noted evidence that the device was not used as intended.This issue may occur when after firing the unit the lockout engages.If the unit was unclamped and then clamped again the lockout gets caught and causes the observed damage.The staples visible in the proximal end condition may occur if the firing stroke is not complete and the firing knob is not fully retracted after firing or if the instrument is applied against an excessive amount of tissue during the clinical application.If the firing knob is not fully retracted, difficulty in unloading the loading unit may be experienced, and may prevent further loading from occurring.The manufacturing records for each device are thoroughly reviewed prior to release to ensure that it meets all medtronic quality specifications.A secondary review of the device history records found no potentially contributing factors.The instructions included with this device provide the following guidance: when a fired instrument is opened, the lockout device will deploy.The safety lock out prevents clamping of the instrument with a cartridge that has been fired.To remove the sulu, separate the instrument halves.Holding the cartridge-half of the instrument, grasp the proximal end of the sulu tabs and pull up and out to remove the sulu from the instrument.To place a new sulu into the instrument, hold the sulu by the proximal end tabs and insert into the cartridge fork at a 30 to 45 degree angle from the distal end down until the unit snaps into place.Remove shipping wedge after sulu is fully loaded.Sulu will ¿float¿ up and down in final loaded position.Medtronic submits this report to comply with fda regulations 21 cfr parts 4 and 803.Medtronic has made reasonable efforts to provide as much relevant information as is available to the company as of the submission date of this report.This report does not constitute an admission or a conclusion by fda, medtronic, or its employees that the device, medtronic, or its employee caused or contributed to the event described in the report.Any required fields that are unpopulated are blank because the information is currently unknown or unavailable.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
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Brand Name
GIA
Common Device Name
STAPLER, SURGICAL
Manufacturer (Section D)
COVIDIEN SURGICAL
60 middletown ave
north haven CT 06473
Manufacturer (Section G)
COVIDIEN SURGICAL
60 middletown ave
north haven CT 06473
Manufacturer Contact
mike bocchino
8200 coral sea st ne
mounds view, MN 55112-4391
8006464633
MDR Report Key23974837
Report Number1219930-2026-00092
Device Sequence Number4554084
Product Code GAG
UDI-Device Identifier10884521723528
UDI-Public(01)10884521723528(17)290731(10)N4H1573UY(20)02
Combination Product (Y/N)N
Initial Reporter CountryUK
PMA/510(K) Number
K221006
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other Health Care Professional
Type of Report Initial,Followup,Followup
Report Date (Section B) 03/19/2026
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 Model NumberGIA80MTC
Device Catalogue NumberGIA80MTC
Device Lot NumberN4H1573UY
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/19/2025
Supplement Date Received by Manufacturer01/21/2026
03/16/2026
Initial Report FDA Received Date01/06/2026
Supplement Report FDA Received Date01/22/2026
03/19/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured08/06/2024
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 Age83 YR
Patient SexFemale
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