MAUDE MDR 6309141

MDR report key
6309141
Report number
1018120-2017-00024
Event key
0
Event type
3
Date of event
2016-06-01
Date received
2017-02-07
Adverse event
3
Product problem
3
Patients in event
0
Reporter occupation
0
Health professional
3
Initial report to FDA
3
Event location
3

Manufacturer Contact#

Contact
EDWARD ALMEIDA
Address
15 HAMPSHIRE ST. MANSFIELD MA 02048 US
Phone
508-508-5084
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
103201 EYE PADSEYE GAUZE PADCOVIDIENHMP032010320115M171162Y Y

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12017-02-070

Event Narratives#

N

Patient 1

A DEVICE HISTORY RECORD REVIEW OF THE REPORTED LOT NUMBER CONFIRMED THAT THE PRODUCT WAS PRODUCED ACCOMPLISHING QUALITY REQUIREMENTS AND RELEASED ACCORDING TO ESTABLISHED PROCEDURES. A REVIEW OF MAINTENANCE RECORDS (BOTH CORRECTIVE AND PREVENTIVE) AND CALIBRATION RECORDS WERE REVIEWED THERE WERE NO ISSUES. ALL SCHEDULED MAINTENANCE AND CALIBRATION ACTIVITIES WERE COMPLETED ON TIME. THERE WERE NO RELATED PROCESS OR MATERIAL CHANGES RELATED TO THE REPORTED CONDITION FOR THIS PRODUCT OR DESCRIBE CHANGES THAT OCCURRED. THE OEE SHEET FOR THE LINE ON THIS DAY SHOWS NO UNUSUAL DOWNTIME OR EVENT THAT COULD CAUSE THIS ISSUE. A REVIEW OF THE MACHINE SETUP WAS CONDUCTED AND ALL MACHINE PARAMETERS WERE SET WITHIN VALIDATED SPECIFICATIONS. ALL IN PROCESS CHECKS WERE CONDUCTED AND FOUND NO ISSUES. PHOTOS WERE PROVIDED FOR SAMPLE ANALYSIS. THE PHOTOS INDICATED A SMALL TEAR IN THE CENTER OF EACH PAD WITHIN THE SEAL TOWARD THE BOTTOM OF THE PACKAGE. THE SAME TEARS ARE SEEN ON MULTIPLE PACKAGES. THE DEFECT IS CONFIRMED. THE CUSTOMER SENT BACK 7 BOXES OF SAMPLES THAT WERE UNOPENED AND UNUSED ON 10/20/2016. AFTER A 100% INSPECTION, NO PACKAGES WITH THE SMALL TEARS PICTURED IN THE PHOTOS TAKEN BY THE CUSTOMER WERE FOUND. ON THIS MACHINE, A CHAIN WITH METAL TABS CARRIES THE EYEPAD CUTOUT FROM THE COTTON TOWARD THE PAPER TO BE PACKAGED. AS IT APPROACHES THE AREA TO BE INSERTED BETWEEN THE PAPER, THE METAL TABS ROTATE ALONG A ROLLER AND MOVE OUT OF THE WAY TO NOT MAKE CONTACT WITH THE PAPER. THIS ISSUE COULD HAVE OCCURRED FROM A BENT TAB SUCH THAT IT MADE A SMALL HOLE EVERY SEVERAL TABS. A FORMAL CORRECTIVE AND PREVENTATIVE ACTION HAS BEEN OPENED FOR THIS ISSUE. IT MUST BE NOTED THAT IN-PROCESS CONTROLS ARE IN PLACE TO PREVENT NONCONFORMING PRODUCT FROM LEAVING THE MANUFACTURING ACTIVITIES. IN ADDITION, AS A PREVENTIVE ACTION FOR MANUFACTURING SITE OPERATIONS, A MONTHLY COMPLAINTS REPORT IS SENT TO FOCUS FACTORY PERSONNEL, SUMMARIZING THE LATEST EVENTS REPORTED BY THE CUSTOMER.

D

Patient 1

IT WAS REPORTED TO COVIDIEN ON (B)(6) 2016 THAT A CUSTOMER HAD AN ISSUE WITH AN EYE GAUZE PAD. THE CUSTOMER STATES THERE ARE HOLES/TEARS IN THE PEEL POUCH.