MAUDE MDR 1017141

MDR report key
1017141
Report number
1119779-2008-00005
Event key
0
Event type
3
Date of event
2008-02-25
Date received
2008-03-20
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
100
Health professional
3
Initial report to FDA
3
Event location
0

Manufacturer Contact#

Contact
JOHN GERLICH
Address
7 LOVETON CIRCLE SPARKS MD 21152 US
Phone
410-410-4103
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1BBL THIOGLYCOLLATE MEDIUM WITHOUT INDICATORBD DIAGNOSTICSJSG2217987302935N*Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12008-03-2001. O

Event Narratives#

D

Patient 1

CUSTOMER CALLED TO REPORT THAT CAPS ON THE MEDIA WERE TOO TIGHT. AN EMPLOYEE BROKE THE GLASS TUBE IN HER HAND WHILE ATTEMPTING TO OPEN IT. THE EMPLOYEE'S FINGER WAS CUT AND REQUIRED STITCHES. THE EMPLOYEE ALSO RECEIVED A TETANUS SHOT.

N

Patient 1

THE 97 TUBES FROM THIS LOT WERE RETURNED FROM THE CUSTOMER FOR INVESTIGATION. FIVE TUBES WERE OPENED EASILY BY HAND. TEN RANDOM TUBES WERE TESTED FOR TORQUE WITH READINGS FROM 3.4 TO 7.9 IN/LB. TWO OF THE TEN TUBES TESTED FOR TORQUE WERE UNABLE TO BE OPENED. AN ADDITIONAL 25 TUBES WERE TESTED FOR TORQUE AND SIX WERE HIGHER THAN 8 IN/LB. THE REMAINING 19 WERE WITHIN THE SATISFACTORY RANGE OF 3.0-8.0 IN/LB. ADDITIONALLY, THESE 25 TUBES WERE MEASURED FOR CRITICAL DIMENSIONS AND FOUND TO BE WITHIN SPECIFICATION. RETENTION SAMPLES WERE TESTED FOR EASE TO OPEN AND TORQUE. THREE TUBES WERE EASY TO OPEN AND TWO TUBES WERE VERY HARD TO OPEN. THE TORQUE TESTING RESULTS WERE BETWEEN 5.2 TO 8.0 IN/LB. THE BATCH HISTORY RECORD WAS EXAMINED AND FOUND TO BE SATISFACTORY WITH ALL TORQUE READINGS BETWEEN 4.5 AND 6.4 IN/LB DURING FILLING. A REVIEW OF THE COMPLAINT SYSTEM WAS CONDUCTED AND SHOW NO OTHER REPORTED OF THIS DEFECT ON THIS PRODUCT LOT. THIS LOT WILL BE MONITORED FOR FUTURE REPORTS OF THIS DEFECT. A CORRECTIVE ACTION HAS BEEN OPENED TO FURTHER ADDRESS THIS ISSUE.