BARRIER EXTRA PROTECTION SURGICAL GOWN, LG 0575

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed from a 05,06 report with the FDA on 2003-11-07 for BARRIER EXTRA PROTECTION SURGICAL GOWN, LG 0575 manufactured by Molnlycke Health Care Ab.

Event Text Entries

[296336] Nurse reported strikethrough while evaluating an impervious gown. However, it was not confirmed that fluid actually struck through to the user's scrubs. No known bloodborne pathogens; no adverse clinician impact reported.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number2523357-2003-00008
MDR Report Key494997
Report Source05,06
Date Received2003-11-07
Date of Report2003-11-07
Date of Event2003-10-06
Date Mfgr Received2003-10-06
Device Manufacturer Date2002-01-01
Date Added to Maude2003-11-14
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location0
Manufacturer ContactJOHN CLAY
Manufacturer Street826 NEWTOWN-YARDLEY RD.
Manufacturer CityNEWTOWN PA 18940
Manufacturer CountryUS
Manufacturer Postal18940
Manufacturer Phone8008824582
Manufacturer G1*
Manufacturer Street160 MOO 17 BANGPLEE IND. BANGNA-TRAD RD KM 23, SAMUTPRA
Manufacturer CityTAMBOL BANGSAOTHONG
Manufacturer CountryTH
Single Use3
Remedial ActionOT
Previous Use Code3
Removal Correction NumberNA
Event Type3
Type of Report3

Device Details

Brand NameBARRIER EXTRA PROTECTION SURGICAL GOWN, LG
Generic NameGOWN, SURGICAL
Product CodeFYE
Date Received2003-11-07
Returned To Mfg2003-10-08
Model NumberNA
Catalog Number0575
Lot NumberZ240102F06
ID NumberNA
Device Expiration Date2007-01-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityR
Device Eval'ed by MfgrY
Implant FlagN
Date RemovedA
Device Sequence No1
Device Event Key483724
ManufacturerMOLNLYCKE HEALTH CARE AB
Manufacturer AddressBOX 13080 GOTEBORG SW SE-402 52
Baseline Brand NameBARRIER SURGICAL GOWN
Baseline Generic NameGOWN, SURGICAL
Baseline Catalog No0575
Baseline ID9675
Baseline Device FamilySURGICAL GOWNS
Baseline Shelf Life ContainedY
Baseline Shelf Life [Months]60
Baseline PMA FlagN
Baseline 510K PMNY
Premarket NotificationK760903
Baseline PreamendmentN
Baseline TransitionalN
510k ExemptN


Patients

Patient NumberTreatmentOutcomeDate
101. Other 2003-11-07

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