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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: Covidien Endo GIA; STAPLE, IMPLANTABLE

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Covidien Endo GIA; STAPLE, IMPLANTABLE Back to Search Results
Model Number EGIA45AMT
Medical Device Problem Codes Failure to Fire (2610); Expulsion (2933)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 07/28/2026
Type of Reportable Event Malfunction
Event or Problem Description
According to the reporter, during a laparoscopic rectal resection, when the jaws were closed and after pressing the green button, the firing could not be performed at all. a stapling near the proximal side of the cartridge's jaws was found after the firing attempt.A new cartridge was used to resolve the issue.There was no patient injury.
 
Additional Manufacturer Narrative
D10 concomitant products: sigphandle sig power sigphandle handle - (serial # unknown); sigpshell sig power sigpshell control shell - (lot # unknown); sigadaptstnd sig power sigadaptstnd linear adapter - (serial # unknown).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.
 
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Brand Name
Endo GIA
Common Device Name
STAPLE, IMPLANTABLE
Manufacturer (Section D)
Covidien
sabanetas industrial park
ponce PR 00716 -440
Manufacturer (Section G)
Covidien
sabanetas industrial park
ponce PR 00716 -440
Manufacturer Contact
mike bocchino
8200 coral sea st ne
mounds view, MN 55112--439
+1(800)646-4633
MDR Report Key50275606
Report Number2647580-2026-02395
Device Sequence Number18659129
Product Code GDW
UDI-Device Identifier10884523003154
UDI-Public(01)10884523003154(17)301231(10)P6A1218(20)03
Combination Product (Y/N)N
Initial Reporter CountryJA
PMA/510(K) Number
K111825
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)N
Reporter Type Manufacturer
Report Source Foreign,Health Professional,Company Representative
Type of Report Initial
Report Date (Section B) 08/17/2026
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 NumberEGIA45AMT
Device Catalogue NumberEGIA45AMT
Device Lot NumberP6A1218
Was Device Available for Evaluation? Yes
Date Returned to Manufacturer07/30/2026
Is the Reporter a Health Professional? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/28/2026
Initial Report FDA Received Date08/17/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured01/30/2026
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 Number1
Concomitant Medical Products
and Therapy/Usage Dates
SEE H11
Patient SexUnknown
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