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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC.; INSTRUMENT, ULTRASONIC SURGICAL

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ETHICON ENDO-SURGERY, LLC.; INSTRUMENT, ULTRASONIC SURGICAL Back to Search Results
Catalog Number HARHPGR
Medical Device Problem Code Failure to Read Input Signal (1581)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/01/2026
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that during an unknown procedure the handpiece does not work even after changing ultracision clamp "(41 uses) test x2".
 
Additional Manufacturer Narrative
(b)(4).Date sent: 4/8/2026.D4 batch #: y7056d.Additional information was requested and the following was obtained: were there any patient consequences? if yes, which ones? no investigation summary: the product was returned for evaluation.Visual inspection and functional testing were conducted on the returned device.Visual analysis of the returned sample revealed that the device was returned with no apparent damage.It was connected to a generator, evaluated with a test instrument and the hand activation feature was non-functional.However, it worked properly with footswitch assembly.No communication issues were observed at any time during the testing.The instrument was disassembled to perform an internal electrical test that revealed a hand activation open circuit condition at the cable level, affecting the functionality of the handpiece.Also, the moisture indicator was positive.The handpiece has a number of seals to prevent fluids from entering the housing."positive moisture indicator¿ describes a condition where water enters the handpiece cavity during the steam sterilization process.The primary path of ingress is the distal seal, this may be caused by a reduction of the compressive force on the distal seal.However, no definitive root cause could be drawn.A manufacturing record evaluation was performed for the finished device batch number, and no non-conformances were identified.As part of the quality process, all devices are manufactured, inspected, and released to approved specifications.No conclusion could be reached as to what could have caused this issue.Although no conclusion could be reach on the cause of the reported event.It is probable that the ingress of moisture affected handpiece functionality.
 
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Common Device Name
INSTRUMENT, ULTRASONIC SURGICAL
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 Key24816879
Report Number3005075853-2026-02640
Device Sequence Number20369902
Product Code LFL
UDI-Device Identifier20705036023422
UDI-Public(01)20705036023422
Combination Product (Y/N)N
Initial Reporter CountryFR
PMA/510(K) Number
K002906
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Foreign,Health Professional
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 04/08/2026
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 NumberHARHPGR
Device Lot NumberY7056D081
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/24/2026
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 03/25/2026
Initial Report FDA Received Date04/08/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured11/05/2024
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Reuse
Patient Sequence Number1
Patient SexUnknown
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