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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. GREEN RELOAD FOR ECHELON 45; STAPLE, IMPLANTABLE

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ETHICON ENDO-SURGERY, LLC. GREEN RELOAD FOR ECHELON 45; STAPLE, IMPLANTABLE Back to Search Results
Catalog Number ECR45G
Medical Device Problem Code Failure to Fire (2610)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 12/23/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Date sent 1/26/2026.Investigation summary: the product was returned for evaluation.Visual inspection and functional testing were conducted on the returned reload.Visual analysis of the returned sample revealed that the ecr45g reload was returned unfired with an open package, the reload pan detached.In addition, 1 single driver out of position and 6 double drivers missing, making the reload non-functional.No functional test was performed due the condition of the reload.It is also possible that handling by the customer could dislodge the pan.Dislodgement as a result of the removal of the reload from the device is the most likely scenario.Please reference the instruction for use for more information.As part of our quality process, the manufacturing records of this batch number were reviewed, and the manufacturing standards were met prior to the release of this batch.As part of ethicon endo surgery¿s quality process, all devices are manufactured, inspected, and released to approved specifications.Manufacturing record evaluation is not required as the reported event is not associated with the manufacturing process and/or the potential cause of the defect cannot be associated to manufacturing.
 
Event or Problem Description
It was reported that during an unknown surgery, could not fire.Changed the new one to complete surgery.There was no patient consequence reported.No additional information can be provided.
 
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Brand Name
GREEN RELOAD FOR ECHELON 45
Common Device Name
STAPLE, IMPLANTABLE
Manufacturer (Section D)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
*  00969
Manufacturer (Section G)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
*   00969
Manufacturer Contact
orla o'mahony
475 calle c
guaynabo 
*  
3035526892
MDR Report Key24177492
Report Number3005075853-2026-00790
Device Sequence Number13154123
Product Code GDW
UDI-Device Identifier10705036001744
UDI-Public(01)10705036001744(17)270531(10)866A41(21)
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K051002
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 01/26/2026
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 NumberECR45G
Device Lot Number866A41
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/09/2026
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/15/2026
Initial Report FDA Received Date01/26/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/05/2022
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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