NI 622258

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2015-06-16 for NI 622258 manufactured by Medline Industries = Phs Packs.

Event Text Entries

[5872309] Phs total knee catalog 622258, lot 1185509 rev 15. Contaminants include: a) ink transfer from time out towel. B) red thread in disposable towel. Same reporter in mw5043161- mw5043178.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report NumberMW5043171
MDR Report Key4859416
Date Received2015-06-16
Date of Report2015-06-16
Date of Event2015-06-01
Date Added to Maude2015-06-23
Event Key0
Report Source CodeVoluntary report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA0
Event Location0
Single Use0
Previous Use Code0
Event Type3
Type of Report3

Device Details

Brand NameNI
Generic NameMODULE OR PACK = TOTAL KNEE
Product CodeLRP
Date Received2015-06-16
Catalog Number622258
Lot Number1185509
Device AvailabilityN
Device Sequence No1
Device Event Key0
ManufacturerMEDLINE INDUSTRIES = PHS PACKS
Manufacturer AddressONE MEDLINE PLACE MUNDELEIN IL 60060 US 60060


Patients

Patient NumberTreatmentOutcomeDate
10 2015-06-16

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