MAUDE MDR 7439949

MDR report key
7439949
Report number
1423395-2018-00017
Event key
0
Event type
3
Date of event
2018-02-15
Date received
2018-04-18
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
NIGEL VILCHES
Address
THREE LAKES DRIVE NORTHFIELD IL 60093 US
Phone
224-224-2249
Report source
M
Manufacturer link flag
Y

Devices#

Seq, Brand, Generic table
SeqBrandGenericManufacturerProduct codeModelCatalogLotPMA510(k)ImplantEvaluatedAvailability
1ANGIO TRAYMEDLINE INDUSTRIES INC.OEQDYNJ49372AY R

Patients#

Sequence, Received, Treatment table
SequenceReceivedTreatmentOutcome
12018-04-1801. O

Event Narratives#

N

Patient 1

IT WAS REPORTED THAT THE OPERATING (OR) TOWEL SHED LINT DURING AN UNIDENTIFIED CATH LAB PROCEDURE. PER THE FACILITY, LINTING WAS DISCOVERED ON AN UNIDENTIFIED DEVICE AFTER IT WAS WIPED WITH THE TOWEL. IT IS UNKNOWN AT WHAT POINT IN THE PROCEDURE THE REPORTED TOWEL LINTING OCCURRED. PER THE FACILITY, THERE WAS NO EFFECT ON PATIENT STABILITY. NO IMPACT TO THE PROCEDURE WAS REPORTED. NO SERIOUS INJURY, FOLLOW-UP CARE, OR MEDICAL INTERVENTION WAS REPORTED. A SAMPLE WAS RECEIVED BY THE MANUFACTURER AND THE REPORTED PRODUCT ISSUE WAS CONFIRMED. DESPITE GOOD FAITH EFFORTS TO OBTAIN ADDITIONAL INFORMATION, THE FACILITY CONTACT WAS UNABLE OR UNWILLING TO PROVIDE ANY FURTHER PATIENT, PRODUCT, OR PROCEDURAL DETAILS TO THE MANUFACTURER. DUE THE REPORTED INCIDENT AND IN AN ABUNDANCE OF CAUTION, THIS MEDWATCH IS BEING FILED. IF ADDITIONAL RELEVANT INFORMATION BECOMES AVAILABLE A SUPPLEMENTAL MEDWATCH WILL BE FILED.

D

Patient 1

IT WAS REPORTED THAT THE OPERATING ROOM (OR) TOWEL SHED LINT DURING AN UNIDENTIFIED CATH LAB PROCEDURE.