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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC. ECHELON ENDOPATH; STAPLE, IMPLANTABLE

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ETHICON ENDO-SURGERY, LLC. ECHELON ENDOPATH; STAPLE, IMPLANTABLE Back to Search Results
Catalog Number GST60B
Medical Device Problem Code Failure to Form Staple (2579)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/21/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
(b)(4).Date sent: 5/4/2026.D4: batch #unk.Attempts have been made to retrieve the device.To date the device has not been returned.If the device or further details are received at a later date a supplemental medwatch will be sent.A manufacturing record evaluation was performed for the finished device batch number of 755d32 / 22gst60b, 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 an unspecified surgical procedure, it was observed that the staples were malformed after firing.Changed to a new one to complete the procedure.There was no patient consequence nor surgical delay reported.No additional information provided.
 
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Brand Name
ECHELON ENDOPATH
Common Device Name
STAPLE, IMPLANTABLE
Manufacturer (Section D)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
Manufacturer (Section G)
ETHICON ENDO-SURGERY, LLC.
475 calle c
guaynabo 00969
Manufacturer Contact
orla o'mahony
475 calle c
guaynabo 00969
3035526892
MDR Report Key25071313
Report Number3005075853-2026-03332
Device Sequence Number16124581
Product Code GDW
UDI-Device Identifier10705036014706
UDI-Public(01)10705036014706(17)280831(10)755D32
Combination Product (Y/N)N
Initial Reporter CountryCH
PMA/510(K) Number
K183435
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,Followup
Report Date (Section B) 06/09/2026
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 NumberGST60B
Device Lot Number755D32
Was Device Available for Evaluation? Device Returned to Manufacturer
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/21/2026
Supplement Date Received by Manufacturer06/02/2026
Initial Report FDA Received Date05/04/2026
Supplement Report FDA Received Date06/09/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/15/2025
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
Patient SexUnknown
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