MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2019-04-11 for MINOR PACK DYNJ49355 manufactured by Medline Industries, Inc..
[141935049]
As the medline industries, minor pack was opened and the bulb syringe was removed from the styrofoam tray, it was noted that there was a significant amount of residual foam on the bulb of the hub syringe. This device was removed from the field and replaced. Fda safety report (b)(4).
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW5085816 |
| MDR Report Key | 8509198 |
| Date Received | 2019-04-11 |
| Date of Report | 2019-04-09 |
| Date of Event | 2019-04-08 |
| Date Added to Maude | 2019-04-12 |
| Event Key | 0 |
| Report Source Code | Voluntary report |
| Manufacturer Link | N |
| Number of Patients in Event | 0 |
| Adverse Event Flag | 3 |
| Product Problem Flag | 3 |
| Reprocessed and Reused Flag | 3 |
| Health Professional | 3 |
| Initial Report to FDA | 3 |
| Report to FDA | 3 |
| Event Location | 3 |
| Single Use | 3 |
| Previous Use Code | 3 |
| Event Type | 3 |
| Type of Report | 0 |
| Brand Name | MINOR PACK |
| Generic Name | LAPAROSCOPY KIT |
| Product Code | FDE |
| Date Received | 2019-04-11 |
| Model Number | DYNJ49355 |
| Catalog Number | DYNJ49355 |
| Lot Number | 18LBK715 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDLINE INDUSTRIES, INC. |
| Manufacturer Address | NORTHFIELD IL 60093 US 60093 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2019-04-11 |