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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: COVIDIEN SURGICAL TRI-STAPLE 2.0; STAPLE, IMPLANTABLE

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COVIDIEN SURGICAL TRI-STAPLE 2.0; STAPLE, IMPLANTABLE Back to Search Results
Model Number SIG60AXT
Medical Device Problem Code Adverse Event Without Identified Device or Use Problem (2993)
Health Effect - Clinical Codes Hemorrhage/Blood Loss/Bleeding (1888); Tissue Breakdown (2681)
Date of Event 02/18/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
D10 concomitant product: sig60axt, tri 2.0 sig60axt 60 xtra thk 15mm (lot#n5h1843y); egia60amt, egia60amt egia 60 artic med thick sulu (lot#p5k1327); egia60amt, egia60amt egia 60 artic med thick sulu (lot#p5l0835); egia60avm, egia60avm egia 60 artic vasc med sulu (lot#p5k1149); egia45amt, egia45amt egia 45 artic med thick sulu (lot#p5j1017); egia60amt, egia60amt egia 60 artic med thick sulu (lot#p5k1327) 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.
 
Event or Problem Description
It was reported that during a robotic assisted laparoscopic gastric sleeve, staple line bleeding was observed 10¿15 minutes after firing four reloads.All staple lines required clipping.
 
Additional Manufacturer Narrative
Correction: b5 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.
 
Event or Problem Description
It was reported that during a robotic assisted laparoscopic gastric sleeve, oozing staple line bleeding was observed 10¿15 minutes after firing seven reloads.All staple lines required clipping.
 
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Brand Name
TRI-STAPLE 2.0
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 Key24631937
Report Number1219930-2026-01716
Device Sequence Number21078994
Product Code GDW
UDI-Device Identifier10884521543591
UDI-Public(01)10884521543591(17)300731(10)N5H1843Y(20)03
Combination Product (Y/N)N
Initial Reporter StateTX
Initial Reporter CountryUS
PMA/510(K) Number
K160176
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Health Professional,Company Representative
Initial Reporter Occupation Physician
Type of Report Initial,Followup
Report Date (Section B) 03/27/2026
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 NumberSIG60AXT
Device Catalogue NumberSIG60AXT
Device Lot NumberN5H1843Y
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 02/23/2026
Supplement Date Received by Manufacturer03/24/2026
Initial Report FDA Received Date03/18/2026
Supplement Report FDA Received Date03/30/2026
Date Device Manufactured08/30/2025
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
PLEASE SEE NOTE ON H11.
Patient SexUnknown
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