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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN SURGICAL POLYSORB; SUTURE, ABSORBABLE, SYNTHETIC, POLYGLYCOLIC AC

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COVIDIEN SURGICAL POLYSORB; SUTURE, ABSORBABLE, SYNTHETIC, POLYGLYCOLIC AC Back to Search Results
Model Number CL-944
Medical Device Problem Code Detachment of Device or Device Component (2907)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 02/19/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
D10 concomitant product: cl-944 polysorb* 0 vio 90cm kv34 x36 (lot#: a5f2019y).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.Medtronic will submit a supplemental report if additional relevant information becomes known.
 
Event or Problem Description
It was reported that during a procedure, while suturing, the needle detached from the suture.The issue occurred with about two sutures from the same box, and the same problem was observed.A new box was opened and used without issue.No patient complications have been reported as a result of this event.
 
Additional Manufacturer Narrative
Additional information: d9, g3, h2, h3, h6 h3 evaluation summary: medtronic conducted an investigation based upon all information received.Twenty-eight representative devices were available for eva luation.Visual inspection noted varying degrees of discoloration (dark color) and suture stiffness were noted near the needle attachment point of the sutures.Functional testing found that the breathable pouches were opened without any tears of the tyvek packaging.The sutures were removed from the retainers without any difficulty.The sutures were loaded onto an instron machine by clamping the needle with a pneumatic grip with a serrated face and the suture end with a pneumatic yarn grip.No suture breakage or fraying was noted while handling or loading the sutures into the instron machine.The instron then pulled the sutures at a rate of 300 mm/min until the needle disengaged from the sutures.The load force at the point of detachment was measured and the results were found to meet the mean and individual specifications.In addition to testing against the specifications, the samples were subjected to testing of the needle attachment force at 90° (degrees) of rotation.Results demonstrated lower forces than are typical for 90° attachment forces of this size suture.It was reported that the needle was detached from the strand several times.The reported issue was confirmed.The most likely cause was determined to be manufacturing related.Internal process improvements have been initiated to mitigate this issue.The manufacturing records for each device are thoroughly reviewed prior to release to ensure that it meets all medtr onic quality specifications.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
POLYSORB
Common Device Name
SUTURE, ABSORBABLE, SYNTHETIC, POLYGLYCOLIC AC
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 Key24513530
Report Number1219930-2026-01465
Device Sequence Number10297466
Product Code GAM
UDI-Device Identifier10884521043602
UDI-Public(01)10884521043602(17)300531(10)A5F2019Y(20)01
Combination Product (Y/N)N
Initial Reporter CountryCA
PMA/510(K) Number
K963253
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,Followup
Report Date (Section B) 06/02/2026
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 NumberCL-944
Device Catalogue NumberCL-944
Device Lot NumberA5F2019Y
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 02/25/2026
Supplement Date Received by Manufacturer05/13/2026
Initial Report FDA Received Date03/04/2026
Supplement Report FDA Received Date06/02/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured06/25/2025
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
Concomitant Medical Products
and Therapy/Usage Dates
SEE NOTE ON H11
Patient SexUnknown
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