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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN SURGICAL RELIATACK; STAPLE, IMPLANTABLE

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COVIDIEN SURGICAL RELIATACK; STAPLE, IMPLANTABLE Back to Search Results
Model Number RELTACK4XDPT
Medical Device Problem Code Failure to Advance (2524)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/19/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during a laparoscopic umbilical hernia procedure, when the tacker was applied at the end of the surgery to fix the prosthesis, the tacks were able to be fired from the device, but none were able to penetrate or hold onto the tissue.The issue was resolved by taking a new device from the same lot to complete the case.No patient complications have been reported as a result of this event.
 
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.
 
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Brand Name
RELIATACK
Common Device Name
STAPLE, IMPLANTABLE
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 Key24414649
Report Number1219930-2026-01204
Device Sequence Number14965400
Product Code GDW
UDI-Device Identifier10884521202429
UDI-Public(01)10884521202429(17)280930(10)N6A1245Y
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K151659
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
Report Date (Section B) 02/23/2026
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 NumberRELTACK4XDPT
Device Catalogue NumberRELTACK4XDPT
Device Lot NumberN6A1245Y
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/19/2026
Initial Report FDA Received Date02/23/2026
Date Device Manufactured10/07/2025
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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