| Brand Name | PDS |
| Common Device Name | Suture, Surgical, Absorbable |
| Manufacturer (Section D) |
| Ethicon Inc. |
| 1000 route 202 |
| raritan NJ 08869 |
|
| Manufacturer (Section G) |
| Ethicon Inc.-Juarez |
| calle durango #2751 |
|
| ciudad juarez 32575 |
|
MX
32575
|
|
| Manufacturer Contact |
|
orla
o'mahony
|
| 1000 route 202 |
| raritan, NJ 08869
|
|
+1(303)552-6892
|
|
| MDR Report Key | 50916040 |
| Report Number | 2210968-2026-09751 |
| Device Sequence Number | 14801072 |
| Product Code |
NEW
|
| UDI-Device Identifier | 10705031048393 |
| Combination Product (Y/N) | Y |
| Initial Reporter Country | AS |
| PMA/510(K) Number | K212380 |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Foreign,Health Professional,Company Representative |
| Type of Report
| Initial |
| Report Date (Section B) |
09/28/2026 |
| 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 Number | PDP489G |
| Device Lot Number | 106A8X |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 09/20/2026 |
| Initial Report FDA Received Date | 09/28/2026 |
| Was Device Evaluated by Manufacturer? (Y/N) |
No
|
| Date Device Manufactured | 02/08/2025 |
| 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 Number | 1 |
| Patient Sex | Unknown |
|
|