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U.S. Department of Health and Human Services

Class 2 Device Recall Shoulder Pack

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  Class 2 Device Recall Shoulder Pack see related information
Date Initiated by Firm January 11, 2017
Date Posted February 28, 2017
Recall Status1 Terminated 3 on May 03, 2017
Recall Number Z-1369-2017
Recall Event ID 76280
Product Classification Light, surgical, ceiling mounted - Product Code FSY
Product Shoulder Pack, part number AMS2936
Shoulder Pack, part number AMS3638
Shoulder Pack, part number AMS3711(B
Shoulder Pack, part numbere AMS4212
Shoulder Pack, part number AMS6460
Shoulder Pack, part numberPSS1852(A
Code Information Lot number and expiration date  100412, 8/14/2018 100837, 10/19/2019 101181, 10/9/2019 83278, 5/27/2018 83634, 5/20/2017 84945, 6/24/2017 85147, 7/28/2017 85150, 7/15/2018 85258, 6/10/2018 85541, 7/14/2018 85554, 7/2/2018 85555, 7/7/2018 86259, 7/2/2017 86308, 9/20/2018 86488, 10/29/2018 86512, 9/28/2018 86688, 11/16/2019 86747, 8/3/2018 87122, 10/7/2017 87798, 10/28/2017 88399, 10/19/2017 88404, 11/20/2018 89040, 12/14/2017 89088, 12/10/2018 89598, 11/18/2018 89887, 12/16/2018 95111, 12/12/2017 95287, 6/15/2019 95811, 2/23/2018 96607, 1/7/2018 97133, 2/7/2018 97290, 5/22/2019 98325, 3/26/2018 98687, 6/14/2019 99065, 6/13/2018 99548, 9/27/2019
Recalling Firm/
Manufacturer		 Windstone Medical Packaging, Inc.
1602 4th Ave N
Billings MT 59101-1521
For Additional Information Contact Vicki Davis
321-527-7714
Manufacturer Reason
for Recall		 The Medtronic COVER LIGHT HANDLE DISPOSABLE GLOVES of the custom Aligned Medical Solutions (AMS) kits were recalled because gloves may contain splits or holes compromising sterility.
FDA Determined
Cause 2		 Nonconforming Material/Component
Action AMS notified their consignees by Email, Fax, and Phone on 11/11/2017. AMS sent the notification letter, dated January 11, 2017, and provided yellow stickers "Recall Notice" to customers. They are advised to over-label the affected AMS kits at their facilities. Customers were instructed to place sticker in such a way that it would be immediately noticed but should not cover up or conceal any pertinent information such as Pack Number, Pack Name, Lot Number or Expiration Date on a kit. Customers with questions can call Vicki Davis at 321-527-7714 or send email to vdavis@alignedmedicalsolutions.com.
Quantity in Commerce 875 kits
Distribution Distributed in AZ, CA, CO, CT, FL, GA, IL, IN, KS, LA, MA, MD, MI, MN, MO, NC, ND, NE, NJ, NV, OH, PA, TX, UT, VA, and WA.
Total Product Life Cycle TPLC Device Report
1 A record in this database is created when a firm initiates a correction or removal action. The record is updated if the FDA identifies a violation and classifies the action as a recall, and it is updated for a final time when the recall is terminated. Learn more about medical device recalls.
2 Per FDA policy, recall cause determinations are subject to modification up to the point of termination of the recall.
3 For details about termination of a recall see Code of Federal Regulations (CFR) Title 21 §7.55.
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