IV START KIT DYND74284

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2020-03-23 for IV START KIT DYND74284 manufactured by Medline Industries, Inc..

Event Text Entries

[184468014] Dressing type from the iv start kit would not release from patient skin causing skin tear.
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number9864984
MDR Report Key9864984
Date Received2020-03-23
Date of Report2020-02-04
Date of Event2019-09-25
Report Date2020-02-04
Date Reported to FDA2020-02-04
Date Reported to Mfgr2020-03-23
Date Added to Maude2020-03-23
Event Key0
Report Source CodeUser Facility report
Manufacturer LinkN
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Reporter OccupationOTHER HEALTH CARE PROFESSIONAL
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Single Use3
Previous Use Code3
Event Type3
Type of Report3

Device Details

Brand NameIV START KIT
Generic NameGENERAL/PLASTIC SURGICAL PROCEDURE KIT, NON-MEDICATED, SINGLE-USE
Product CodeLRS
Date Received2020-03-23
Catalog NumberDYND74284
Lot Number19SBC751
Device AvailabilityN
Device Eval'ed by Mfgr*
Device Sequence No1
Device Event Key0
ManufacturerMEDLINE INDUSTRIES, INC.
Manufacturer AddressTHREE LAKES DRIVE NORTHFIELD IL 60093 US 60093


Patients

Patient NumberTreatmentOutcomeDate
10 2020-03-23

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