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MAUDE Adverse Event Report: ETHICON ENDO-SURGERY, LLC ECHELON; Stapler, surgical
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ETHICON ENDO-SURGERY, LLC ECHELON; Stapler, surgical
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Model Number
ECH60L
Medical Device Problem Code
Difficult to Remove (1528)
Health Effect - Clinical Code
Insufficient Information (4580)
Date of Event
06/05/2026
Type of Reportable Event
Malfunction
Event or Problem Description
During a lap-appy "[laparoscopic appendectomy]", stapled appy.Went to remove stapler from articulated position and patient could not.Hat to remove port and then stapler.
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Brand Name
ECHELON
Common Device Name
Stapler, surgical
Manufacturer
(Section D)
ETHICON ENDO-SURGERY, LLC
475 calle c
guaynabo PR 00969
MDR Report Key
50753660
Report Number
50753660
Device Sequence Number
18558990
Product Code
GAG
UDI-Device Identifier
10705036034988
UDI-Public
(01)10705036034988(17)280229(10)A97P9K
Combination Product (Y/N)
N
Initial Reporter State
VA
Initial Reporter Country
US
Number of Events Summarized
1
Summary Report (Y/N)
N
Reporter Type
User Facility
Initial Reporter Occupation
Nurse
Type of Report
Initial
Report Date
(Section B)
07/17/2026
Report Date
(Section F)
07/17/2026
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
Device Model Number
ECH60L
Device Catalogue Number
ECH60L
Device Lot Number
A97P9K
Was Device Available for Evaluation?
Yes
Is the Reporter a Health Professional?
Yes
Was the Report Sent to FDA?
Yes
Event Location
Hospital
Date Report to Manufacturer
09/14/2026
Initial Date Received by Manufacturer
Not provided
Initial Report FDA Received Date
09/14/2026
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device
Unknown
Patient Sequence Number
1
Outcome Attributed to Adverse Event
Other;
Patient Sex
Unknown
Date Report Sent to FDA
07/17/2026
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