MAUDE Adverse Event Report: DAVIS & GECK CARIBE LTD MAXON; SUTURE, ABSORBABLE, SYNTHETIC, POLYGLYCOLIC AC

Model Number	8886621321
Medical Device Problem Code	Break (1069)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	03/10/2026
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
D10 concomitant products: 8886621321 8886 6213-21 maxon 5-0 grn 75cm cv22x36 - (lot#d6a2694y); 8886621321 8886 6213-21 maxon 5-0 grn 75cm cv22x36 - (lot#d6a2694y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y); 8886614721-2 maxon 5-0 24 grn cv-11 da 8886614721-2 - (lot#d5g3164y).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
According to the reporter, during a robot-assisted pancreaticoduodenectomy (da vinci), even though the suture is supposed to have high tensile strength, the suture broke on the proximal side relative to the area clamped by the needle holder, and frequent breakage was also observed at the ligation point during the ligation operation.The issue occurred on three sutures from the same box and two from a different kind of sutures.The surgery was completed using another company's product.There was no patient injury.

• Brand Name: MAXON
• Common Device Name: SUTURE, ABSORBABLE, SYNTHETIC, POLYGLYCOLIC AC
• Manufacturer (Section D): DAVIS & GECK CARIBE LTD; zona franca de san isidro; santo domingo 0101 ; DR 0101
• Manufacturer (Section G): DAVIS & GECK CARIBE LTD; zona franca de san isidro; santo domingo 0101 ; DR 0101
• Manufacturer Contact: mike bocchino ; 8200 coral sea st ne; mounds view, MN 55112-4391 ; 8006464633
• MDR Report Key: 24637546
• Report Number: 9612501-2026-00800
• Device Sequence Number: 9876689
• Product Code: GAM
• UDI-Device Identifier: 10884523002300
• UDI-Public: (01)10884523002300(17)301231(10)D6A2694Y(20)01
• Combination Product (Y/N): N
• Initial Reporter Country: JA
• PMA/510(K) Number: K990951
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Device Implanted Year: 2026
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Foreign,Health Professional,Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial
• Report Date (Section B): 03/19/2026

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 Number: 8886621321
• Device Catalogue Number: 8886621321
• Device Lot Number: D6A2694Y
• Was Device Available for Evaluation?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 03/10/2026
• Initial Report FDA Received Date: 03/19/2026
• Date Device Manufactured: 01/06/2026
• 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 Number: 1
• Patient Sex: Unknown