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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. PROXIMATE*RL LINEAR STAPLER; STAPLE, IMPLANTABLE

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ETHICON ENDO-SURGERY, LLC. PROXIMATE*RL LINEAR STAPLER; STAPLE, IMPLANTABLE Back to Search Results
Catalog Number TX60B
Medical Device Problem Code Delivered as Unsterile Product (1421)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/15/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Date sent: 2/4/2026.D4: batch # 806d63.Investigation summary: the product was returned to ethicon endo-surgery for evaluation.Visual inspection was conducted on the returned device.Visual analysis of the returned sample revealed that the tx60b tyvek was returned.Upon visual inspection, it was noted that the tyvek has adhered to the blister in the easy opening area.Possible causes of tyvek delamination are tyvek quality, seal strength, or opening technique.However, this condition of the returned tyvek does not affect the sterility.No conclusion could be reached as to what may have caused the condition of the tyvek delaminated.The event described could not be confirmed since the condition of the tyvek does not affect the sterility of the packaging.As part of ethicon endo surgery¿s quality process, all devices are manufactured, inspected, and released to approved specifications.Device history review a manufacturing record evaluation was performed for the finished device batch number of 806d63 /48tx60b , 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.
 
Event or Problem Description
It was reported that during an unk procedure the stapler paper felt too thin and ripped easily - seemed to not have integrity.No patient consequences were reported.
 
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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 Key24260778
Report Number3005075853-2026-01022
Device Sequence Number9600063
Product Code GDW
UDI-Device Identifier10705036003342
UDI-Public(01)10705036003342(17)300930(10)806D63
Combination Product (Y/N)N
Initial Reporter CountryCA
PMA/510(K) Number
K020779
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) 02/04/2026
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 NumberTX60B
Device Lot Number806D63
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer01/26/2026
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 01/14/2026
Initial Report FDA Received Date02/04/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/28/2025
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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