FDA Adverse Event Malfunction Summary report: N

ECHELON*FLEX60 LONG

MDR report key: 1980349 · Received February 7, 2011

Report

Report Number
3005075853-2011-00483
Event Type
Malfunction
Date Received
February 7, 2011
Date of Event
January 6, 2011
Report Date
January 18, 2011
Manufacturer
ETHICON ENDO-SURGERY, LLC.
Product Code
GDW
PMA / PMN Number
K081146
Removal / Correction Number
NA
Product Problem
Yes
Report Source
Manufacturer report
Reporter Location
CA
Reporter Occupation
OTHER

Narratives

Additional Manufacturer Narrative · 1

(B)(4). THE ANALYSIS FOUND THAT THE LONG60A DEVICE WAS RECEIVED IN GOOD VISUAL CONDITION AND WITH A ECR60W RELOAD LOADED IN THE DEVICE. THE RELOAD WAS RECEIVED FULLY FIRED. THE DEVICE WAS TESTED FOR FUNCTIONALITY IN THE ARTICULATED POSITION WITH A TEST CARTRIDGE RELOAD AND IT FIRED, CUT AND FORMED ALL THE STAPLES AS INTENDED. THE CUT WAS NOTED TO BE JAGGED DUE TO A DAMAGED KNIFE. ONE POSSIBLE CAUSE FOR THIS TYPE OF DAMAGE TO THE KNIFE IS WHEN THE DEVICE IS FIRED OVER AN ALREADY EXISTING STAPLE LINE, HARD OBJECT OR THICKER TISSUE THAN INDICATED. REPEATEDLY FIRING ACROSS EXISTING STAPLE LINES CAN ALSO REDUCE THE ABILITY TO CUT CLEANLY. TO MITIGATE THE POTENTIAL FOR STAPLES GETTING INTO THE CARTRIDGE AND INTERFERING WITH THE KNIFE PATH DURING DEVICE FIRING, PRIOR TO RELOADING THE DEVICE, RINSE THE ANVIL AND CARTRIDGE JAW IN STERILE SOLUTION AND THEN WIPE THE ANVIL AND CARTRIDGE JAW TO CLEAN ANY FORMED BUT UNUSED STAPLES FROM THE DEVICE. ADDITIONALLY, PROPER CARE SHOULD BE TAKEN WHEN PLACING THE DEVICE ON THE TISSUE TO BE STAPLED, TO ENSURE THAT NO HARD OBSTRUCTION SUCH AS A CLIP IS INCLUDED WITH THE TISSUE INSIDE THE JAWS. THE EVENT COULD NOT BE CONFIRMED AS THE DEVICE WAS RECEIVED IN THE OPENED POSITION AND THE DEVICE OPENED AND CLOSED WITHOUT ANY DIFFICULTIES NOTED. AS PART OF OUR QUALITY PROCESS, EACH DEVICE IS VISUALLY INSPECTED AND FUNCTIONALLY TESTED DURING MANUFACTURING TO ENSURE THAT THE DEVICE MEETS THE REQUIRED SPECIFICATIONS PRIOR TO SHIPMENT. A BATCH RECORD REVIEW WAS PERFORMED AND NO ANOMALIES WERE FOUND DURING THE MANUFACTURING PROCESS.

Additional Manufacturer Narrative · 1

(B)(4). AFTER SEVERAL REQUESTS, THE DEVICE WAS NOT RECEIVED FOR ANALYSIS.

Additional Manufacturer Narrative · 1

(B)(4): INFORMATION ANTICIPATED, BUT UNAVAILABLE AT THIS TIME.

Description of Event or Problem · 1

IT WAS REPORTED THAT DURING A GASTRIC BYPASS PROCEDURE, AFTER THE 11TH FIRING THE DEVICE JAWS WOULD NOT OPEN. IT IS UNKNOWN AT THIS TIME HOW THE DEVICE WAS REMOVED FROM THE BOWEL OR HOW THE CASE WAS COMPLETED. THERE WAS NO ADVERSE CONSEQUENCE TO THE PATIENT. (B)(4)

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 ECHELON*FLEX60 LONG STAPLE, IMPLANTABLE GDW ETHICON ENDO-SURGERY, LLC. UNK NI

Patients

Seq Age Sex Outcome Treatment
1