NS-3600-B LITE GLOVE 1000/CASE 571711

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2016-08-02 for NS-3600-B LITE GLOVE 1000/CASE 571711 manufactured by Covidien.

Event Text Entries

[52322107] Submit date: 08/02/2016. An investigation is currently underway. Upon completion, the results will be forwarded.
Patient Sequence No: 1, Text Type: N, H10


[52322108] It was reported to covidien on (b)(6) 2016 that a customer had an issue with a lite glove. The customer reports the lite handle cover is splitting. The split was found when placing on the handle during set up. A new glove was placed once the tear was seen. There was no patient in the room when the lite handle glove split.
Patient Sequence No: 1, Text Type: D, B5


[60914006] A review of the device history record (dhr) could not be performed or date of manufacture identified as the lot number was not provided. All dhr? S are reviewed for quality inspections and parameter compliance prior to releasing the product for distribution. Because a sample was not returned, we were unable to perform a thorough follow up investigation to include functional and visual evaluations to confirm the reported issue and root cause analysis. A corrective and preventative action (capa) has been opened to determine the root cause of this reported event. When root cause(s) is determined the appropriate actions will be taken to address the reported condition. If additional information is received this complaint will be reopened. This complaint will be used for tracking and trending purposes.
Patient Sequence No: 1, Text Type: N, H10


MAUDE Entry Details

Report Number9612030-2016-00342
MDR Report Key5841903
Date Received2016-08-02
Date of Report2016-07-27
Date Mfgr Received2016-11-17
Date Added to Maude2016-08-02
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 Location3
Manufacturer ContactEDWARD ALMEIDA
Manufacturer Street15 HAMPSHIRE ST
Manufacturer CityMANSFIELD MA 02048
Manufacturer CountryUS
Manufacturer Postal02048
Manufacturer Phone5084524151
Manufacturer G1COVIDIEN
Manufacturer StreetCALLE 9 SUR NO. 125 CUIDAD INDUSTRIAL
Manufacturer CityTIJUANA 92173
Manufacturer CountryMX
Manufacturer Postal Code92173
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameNS-3600-B LITE GLOVE 1000/CASE
Generic NameLITE GLOVE
Product CodeLYZ
Date Received2016-08-02
Model Number571711
Catalog Number571711
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device AgeDA
Device Eval'ed by MfgrR
Device Sequence No1
Device Event Key0
ManufacturerCOVIDIEN
Manufacturer AddressCALLE 9 SUR NO. 125 CUIDAD INDUSTRIAL TIJUANA MX


Patients

Patient NumberTreatmentOutcomeDate
10 2016-08-02

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