MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-09 for CYSTO PACK DYNJ904165B manufactured by Medline Industries - Mundelein.
[183098668]
A foreign object was found in the pack-looked like a piece of skin on the table drape. The pack was discarded and a new one was opened prior to the start of the procedure. Fda safety report id# (b)(4).
Patient Sequence No: 1, Text Type: D, B5
| Report Number | MW5093644 |
| MDR Report Key | 9810977 |
| Date Received | 2020-03-09 |
| Date of Report | 2020-03-05 |
| Date of Event | 2020-03-04 |
| Date Added to Maude | 2020-03-10 |
| 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 |
| Reporter Occupation | RISK MANAGER |
| 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 | 3 |
| Brand Name | CYSTO PACK |
| Generic Name | GENERAL SURGERY TRAY |
| Product Code | LRO |
| Date Received | 2020-03-09 |
| Catalog Number | DYNJ904165B |
| Lot Number | 19KBM267 |
| Operator | HEALTH PROFESSIONAL |
| Device Availability | Y |
| Device Eval'ed by Mfgr | I |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDLINE INDUSTRIES - MUNDELEIN |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-09 |