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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP; SYRINGE,EAR/ULCER, 3 OZ, STERILE

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MEDLINE INDUSTRIES, LP; SYRINGE,EAR/ULCER, 3 OZ, STERILE Back to Search Results
Model Number DYND70277
Device Problem Mechanical Problem (1384)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 02/12/2021
Event Type  malfunction  
Manufacturer Narrative
It was reported that the ear ulcer syringe "appears to be much thicker and it's difficult to compress." to date, no information has been received to indicate that a user or a patient experienced a death, serious injury, medical intervention, follow-up care, or other adverse health impact associated with the reported problem/issue.A sample was provided for evaluation and investigation identified the reported problem/issue to not be a product defect as the sample met specifications.In an abundance of caution, and in response to an fda 483 issued for cfn (b)(4) on 22-jan-2024, this medwatch is being filed.If additional relevant information becomes available a supplemental medwatch will be filed.
 
Event Description
It was reported that the ear ulcer syringe "appears to be much thicker and it's difficult to compress.".
 
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Type of Device
SYRINGE,EAR/ULCER, 3 OZ, STERILE
Manufacturer (Section D)
MEDLINE INDUSTRIES, LP
three lakes drive
northfield IL 60093 2753
Manufacturer Contact
nigel vilches
three lakes drive
northfield, IL 60093-2753
MDR Report Key18954318
MDR Text Key338319971
Report Number1417592-2024-00374
Device Sequence Number1
Product Code KYZ
UDI-Device Identifier40080196862543
UDI-Public40080196862543
Combination Product (y/n)N
Reporter Country CodeUS
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type User Facility
Reporter Occupation Other
Type of Report Initial
Report Date 03/21/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received03/21/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Model NumberDYND70277
Device Lot Number48620040003
Was Device Available for Evaluation? Yes
Date Manufacturer Received02/12/2021
Was Device Evaluated by Manufacturer? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Unknown
Patient Sequence Number1
Patient Outcome(s) Other;
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