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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. PROXIMATE*CUTTER RELOAD UNIT; STAPLE, IMPLANTABLE

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ETHICON ENDO-SURGERY, LLC. PROXIMATE*CUTTER RELOAD UNIT; STAPLE, IMPLANTABLE Back to Search Results
Catalog Number TCR75
Medical Device Problem Code Failure to Fire (2610)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/12/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Date sent: 3/5/2026.D4: batch # 382d39.Investigation summary: the product was returned to ethicon endo-surgery for thorough evaluation, which included visual inspections and functional testing of the returned reload.Visual analysis of the returned sample determined that the tcr75 reload was received with damage on the proximal reload deck and with the proximal 6 drivers up without staples and the remaining drivers down with staples present.In addition, 2 b-formed staples were noted on the damage of the deck and an opened packaging returned along with the reload.The returned reload had the swing tab in the locked position.No functional test was performed in order to preserve the evidence.The event reported was confirmed and it is related to improper use of the reload.It should be noted that the cartridge reload is designed to lockout, as a safety feature, if any staples have been fired from the cartridge reload.In addition, failure to complete the stroke may result in an incomplete staple line.The damage to the reload is consistent with the device being clamped over a hard object.To mitigate the potential for staples getting into the reload and interfering with the knife during device firing, prior to reloading the device, clean in sterile solution and then wipe the anvil and reload channel to clean any formed but unused staples from the device.Additionally, proper care should be taken when placing the device on the tissue to be stapled, to ensure that no hard obstruction such as a clip is included with the tissue inside the jaws.Please reference the instruction for use for more information.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 382d39, 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 the unk surgery, could not fire.Changed another one to continue the surgery, the same problem happened again.Changed the new one to complete surgery.There was no patient consequence reported.No additional information can be provided.
 
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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 Key24521357
Report Number3005075853-2026-01831
Device Sequence Number18555654
Product Code GDW
UDI-Device Identifier10705036013136
UDI-Public(01)10705036013136(17)290831(10)286D48
Combination Product (Y/N)N
Initial Reporter CountryCH
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) 03/05/2026
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 NumberTCR75
Device Lot Number286D48
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/11/2026
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 02/16/2026
Initial Report FDA Received Date03/05/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/27/2024
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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