MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-17 for 7496 HFS MINI PLUS KIT DYNJ10210B manufactured by Medline Industries, Inc..
[183740982]
Upon counts, it was determined that the kit had six 18x18 x-ray lap sponges instead of the five.
Patient Sequence No: 1, Text Type: D, B5
| Report Number | 9840483 |
| MDR Report Key | 9840483 |
| Date Received | 2020-03-17 |
| Date of Report | 2020-03-12 |
| Date of Event | 2020-03-11 |
| Report Date | 2020-03-12 |
| Date Reported to FDA | 2020-03-12 |
| Date Reported to Mfgr | 2020-03-17 |
| Date Added to Maude | 2020-03-17 |
| Event Key | 0 |
| Report Source Code | User Facility 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 | 3 |
| Brand Name | 7496 HFS MINI PLUS KIT |
| Generic Name | GENERAL SURGERY TRAY |
| Product Code | LRO |
| Date Received | 2020-03-17 |
| Model Number | DYNJ10210B |
| Catalog Number | DYNJ10210B |
| Lot Number | 19KBF989 |
| Device Availability | * |
| Device Eval'ed by Mfgr | * |
| Device Sequence No | 1 |
| Device Event Key | 0 |
| Manufacturer | MEDLINE INDUSTRIES, INC. |
| Manufacturer Address | THREE LAKES DRIVE NORTHFIELD IL 60093 US 60093 |
| Patient Number | Treatment | Outcome | Date |
|---|---|---|---|
| 1 | 0 | 2020-03-17 |