FDA Adverse Event Injury Summary report: N

VIA-GUARD STANDARD SUCTION SET

MDR report key: 22730977 · Received August 6, 2025

Report

Report Number
MW5174149
Event Type
Injury
Date Received
August 6, 2025
Date of Event
December 8, 2024
Report Date
July 31, 2025
Manufacturer
SURGIMARK INC
Product Code
JOL
Adverse Event
Yes
Product Problem
Yes
Report Source
Voluntary report
Reporter Location
TX, US
Reporter Occupation
RISK MANAGER
Health Professional
N

Narratives

Description of Event or Problem · 0

ON (B)(6) 2024, THE PATIENT WAS ADMITTED FOR A HEMICOLECTOMY FOR ADENOCARCINOMA OF THE CECUM. THE SUCTION DEVICE USED DURING THE PROCEDURE WAS A VIA-GUARD STANDARD SUCTION SET MADE BY SURGIMARK, INC. IN (B)(6) OF 2025, A ROUTINE IMAGING WAS PERFORMED WHICH REVEALED A RETAINED FOREIGN BODY LOCATED IN THE LOWER LEFT ABDOMEN. ANOTHER SURGICAL PROCEDURE WAS PERFORMED ON (B)(6) 2025. AN OUTER SLEEVE FROM THE SUCTION DEVICE WAS REMOVED. THE SLEEVE IS SEPARATED FROM THE MAIN BODY OF THE INSTRUMENT AND ATTACHED WHEN INDICATED. IN THE FIRST SURGERY, THE SLEEVE WAS USED TO PROVIDE ADDITIONAL SUCTION. APPARENTLY WHEN THE DEVICE WAS RE-MOVED FROM THE ABDOMINAL CAVITY, THE SLEEVE WAS NOT COMPLETELY ATTACHED TO THE MAIN BODY OF THE DEVICE AND WAS NOT REMOVED. THERE IS NO NEGATIVE PATIENT OUTCOME. THERE IS A POTENTIAL DESIGN FLAW WHICH ALLOWS THE SLEEVE TO BECOME DETACHED DURING THE PROCEDURE THUS CREATING A POTENTIAL PATIENT SAFETY ISSUE.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
505563 VIA-GUARD STANDARD SUCTION SET CATHETER AND TIP, SUCTION JOL SURGIMARK INC (10) 60004

Patients

Seq Age Sex Outcome Treatment
1 78 YR Female Required Intervention| H