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U.S. Department of Health and Human Services

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

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ETHICON ENDO-SURGERY, LLC. HARMONIC; INSTRUMENT, ULTRASONIC SURGICAL Back to Search Results
Catalog Number HPBLUE
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
Additional Manufacturer Narrative
(b)(4) date sent: 6/11/2026 d4 batch #: a9d05g.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 received with one of the connector pins damaged.The handpiece was disassembled to verify the condition of the internal components; 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.Although no conclusion could be reach on the cause of the reported event.It is probable that the ingress of moisture affected handpiece functionality.
 
Event or Problem Description
It was reported that during an unknown procedure that the hpblue gave errors.By testing the device it seems to be defect while it still has 29 remaining uses.There were no patient consequences.
 
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Brand Name
HARMONIC
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 Key25469502
Report Number3005075853-2026-04482
Device Sequence Number18748596
Product Code LFL
UDI-Device Identifier20705036002151
UDI-Public(01)20705036002151
Combination Product (Y/N)N
Initial Reporter CountryBE
PMA/510(K) Number
K063192
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) 06/11/2026
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 NumberHPBLUE
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer05/05/2026
Type of Report(Section G)Initial
Initial Date Received by Manufacturer 05/24/2026
Initial Report FDA Received Date06/11/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured05/15/2023
Is the Device Labeled for Single Use? (Y/N) No
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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