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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. VCL CT BRD VIO 8X18IN 3-0 S/A SH CR; SUTURE, ABSORBABLE, SYNTHETIC

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ETHICON INC. VCL CT BRD VIO 8X18IN 3-0 S/A SH CR; SUTURE, ABSORBABLE, SYNTHETIC Back to Search Results
Catalog Number J774D
Medical Device Problem Code Component Missing (2306)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that a patient underwent an unknown procedure on an unknown date and suture was used.When opening the box, there were only 11 packages in it.It was a control release needle.Another product was used to complete the case.No adverse patient consequences were reported.Additional information was requested.
 
Additional Manufacturer Narrative
Product complaint # (b)(4).Additional information was requested, and the following was obtained: - could you kindly provide the lot number, please? 10828g.H3 investigation summary: the product was returned to ethicon for evaluation.One open box with eleven representative unopened samples was received for analysis.Product code j774d.Upon visual inspection of the received box, it was noted that it contained eleven foil packets instead of the required twelve.Additionally, the foil packets were found to be relabeled.However, it could not be determined whether only eleven samples were originally placed inside the box.A manufacturing record evaluation was performed for the finished device batch number, and no non-conformances were identified.Although no conclusion could be reached regarding the cause of the reported event, as part of ethicon's quality process, all devices are manufactured, inspected, and released to approved specifications.Further monitoring of complaint information will be performed for potential safety signals through complaint trending as part of post-market surveillance.A manufacturing record evaluation was performed for the finished device batch number, and no non-conformances were identified.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.
 
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Brand Name
VCL CT BRD VIO 8X18IN 3-0 S/A SH CR
Common Device Name
SUTURE, ABSORBABLE, SYNTHETIC
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-JUAREZ
calle durango #2751
ciudad juarez 32575
MX   32575
Manufacturer Contact
orla o'mahony
1000 route 202
raritan, NJ 08869
3035526892
MDR Report Key23995760
Report Number2210968-2026-00157
Device Sequence Number21392265
Product Code GAM
UDI-Device Identifier10705031042919
UDI-Public(01)10705031042919(17)300331(10)10828G
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K022269
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 01/07/2026
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 Catalogue NumberJ774D
Device Lot Number10828G
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer11/13/2025
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/12/2025
Initial Report FDA Received Date01/07/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured04/28/2025
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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