| Brand Name | COATED VICRYL |
| Common Device Name | SUTURE, ABSORBABLE, SYNTHETIC, POLYGLYCOLIC ACID |
| Manufacturer (Section D) |
| ETHICON INC. |
| route 22 west, p.o. box 151 |
| somerville NJ 08876 |
|
| MDR Report Key | 24454806 |
| Report Number | 24454806 |
| Device Sequence Number | 9403439 |
| Product Code |
GAM
|
| UDI-Device Identifier | 10705031056145 |
| UDI-Public | (01)10705031056145 |
| Combination Product (Y/N) | N |
| Initial Reporter State | AZ |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
User Facility
|
| Initial Reporter Occupation |
Risk Manager
|
| Type of Report
| Initial |
| Report Date (Section B) |
02/18/2026 |
| Report Date (Section F) |
02/18/2026 |
| 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
|
| Device Model Number | VCP946H |
| Device Catalogue Number | VCP946H |
| Device Lot Number | 10BSXJ |
| Is the Reporter a Health Professional? |
No
|
| Was the Report Sent to FDA? |
Yes
|
| Event Location |
Hospital
|
| Date Report to Manufacturer | 02/26/2026 |
| Initial Date Received by Manufacturer | Not provided |
| Initial Report FDA Received Date | 02/26/2026 |
| Usage of Device |
Unknown
|
| Patient Sequence Number | 1 |
| Outcome Attributed to Adverse Event |
Other;
|
| Patient Sex | Female |
| Date Report Sent to FDA | 02/18/2026 |
|
|