MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. GST BLACK RELOAD 60MM 6 ROW; STAPLE, IMPLANTABLE

Catalog Number	GST60T
Medical Device Problem Code	No Apparent Adverse Event (3189)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
(b)(4) date sent: 2/9/2026 b3: unknown d4: batch #unk.Attempts are being made to obtain the following information.To date no response has been provided.If further details are received at a later date a supplemental medwatch will be sent: 1.How was the product purchased? 2.Could you please confirm if the vendor is authorized by (b)(6)? 3.Is there an indication of how the product was distributed? 4.Is there any indication of the source? 5.Based on the packaging, is there any indication of which market the original genuine product may have come from? 6.Please provide a picture (if available): investigation summary: a photo was submitted for evaluation.During the visual analysis, the following was observed: the photos show a tyvek with the product code gst60t, lot # 532t61, exp.Date: 2027-04-30.A lot trace was performed on the lot provided, and the lot number was not found in the quality tracking system.The analysis performed determines that the suspect package is not authentic johnson & johnson product.Based on the photos and lot reviewed, it was confirmed that the product is counterfeit.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 the customer received allegedly defective products.There was no patient consequence reported.No additional information provided.

• Brand Name: GST BLACK RELOAD 60MM 6 ROW
• 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 00969 ; * 00969 ; 3035526892
• MDR Report Key: 24298290
• Report Number: 3005075853-2026-01177
• Device Sequence Number: 9332726
• Product Code: GDW
• UDI-Device Identifier: 10705036014720
• UDI-Public: 10705036014720
• Combination Product (Y/N): N
• Initial Reporter Country: RS
• PMA/510(K) Number: K110385
• Number of Events Summarized: 1
• 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): 02/09/2026

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 Number: GST60T
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 02/02/2026
• Initial Report FDA Received Date: 02/09/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• 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 Number: 1
• Concomitant Medical Products and Therapy/Usage Dates: HANDPIECE AND GENERATOR
• Patient Sex: Unknown