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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: ETHICON INC. COATED VICRYL; SUTURE, ABSORBABLE, SYNTHETIC

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ETHICON INC. COATED VICRYL; SUTURE, ABSORBABLE, SYNTHETIC Back to Search Results
Catalog Number VCP358H
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/25/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Product complaint # (b)(4).This report is being submitted pursuant to the provisions of 21 cfr, part 803, part 4 subpart b.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.A manufacturing record evaluation was performed for the finished device lot, and no non-conformances were identified.The following information was requested, but unavailable: what is the current status of the patient? - do you have any photos available for visual analysis? - please provide the source or name of person providing answers to follow-up questions: received information as following from sales rep via phone today.Please refer to the event description, other information requested is unknown.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.
 
Event or Problem Description
It was reported that a patient underwent a myomectomy procedure on (b)(6) 2026 and suture was used.During the procedure, the patient was hospitalized for uterine fibroids and underwent surgery.During the operation, the chief surgeon sutured the uterine muscle layer according to routine procedures, but the suture tore off and broke.The doctor immediately replaced the suture and re sutured the uterine muscle layer.This incident increased the patient's pain and the.
 
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Brand Name
COATED VICRYL
Common Device Name
SUTURE, ABSORBABLE, SYNTHETIC
Manufacturer (Section D)
ETHICON INC.
1000 route 202
raritan NJ 08869
Manufacturer (Section G)
ETHICON INC.-SAN ANGELO
3348 pulliam st
san angelo TX 76905
Manufacturer Contact
orla o'mahony
1000 route 202
raritan, NJ 08869
3035526892
MDR Report Key25511640
Report Number2210968-2026-06368
Device Sequence Number10506314
Product Code GAM
UDI-Device Identifier10705031052710
UDI-Public(01)10705031052710(17)300228(10)106X93
Combination Product (Y/N)Y
Initial Reporter CountryCH
PMA/510(K) Number
K032420
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Other,Foreign,Health Professional,Company Representative
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 06/15/2026
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 NumberVCP358H
Device Lot Number106X93
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/28/2026
Initial Report FDA Received Date06/15/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured03/06/2025
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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