MAUDE Adverse Event Report: MEX03 MEXICO-JUAREZ PRESOURCE NEURO PACK (SSMSL)167; NEUROLOGICAL TRAY

Model Number SNE22SSMS9

Device Problem Material Frayed (1262)

Patient Problem No Clinical Signs, Symptoms or Conditions (4582)

Event Date 06/15/2021

Event Type  malfunction  

Manufacturer Narrative

Based on supplier investigation, the device history record(dhr) review did not indicate any exception that could lead to the reported incident.The device history record for the lot number reported, 20200922-23-sh, revealed the product was finished on december 13th, 2020.The average linting data is 0.184g/10pcs.The sample was not returned at the time of this investigation, only a photo was provided.A review of the photo revealed blue lint was found on doctor's hands.According to the supplier, or towel is made of cotton, so cotton fiber is born.The supplier is continuously working with cardinal health to better control the linting and have implemented several measures to improve it: a.Suctions machines have been installed in grey cloth rolling process, dyeing process and cutting process.B.The suction process was added before product's final folding, and workers do it according to standard operation procedure requirement.C.Linting test method and acceptable criteria was stipulated to see the suction results.(=0.38g/10pieces).D.In the folding process, supplier used one cloth pad under 100pieces semi-finished products to avoid linting stuck onto the products during product's transfer.From the investigation, no abnormal situation happened in production; therefore, the root cause could not be determined.The complaint information was shared with the relevant sectors for their awareness.There is no action taken at this time, but the supplier will continue to monitor trends for this type of incident.

Event Description

Customer reported blue towels (pwtb04-stm) that come inside the neuro pack (sne22ssms9) are reportedly releasing a great amount of lint.Dr.(b)(6) called the clinical manager into room 12 to show her lint on his hands.No injury reported, but dr.(b)(6) mentioned this has occurred before and he is worried about the lint getting into the surgical wound and the sterile field.

• Brand Name: NEURO PACK (SSMSL)167
• Type of Device: NEUROLOGICAL TRAY
• Manufacturer (Section D): MEX03 MEXICO-JUAREZ PRESOURCE; c. arcadia 1580 , col. terraza; cd.juarez , chihuahua CP 32 599; MX CP 32599
• Manufacturer (Section G): MEX03 MEXICO-JUAREZ PRESOURCE; c. arcadia 1580 , col. terraza; cd.juarez , chihuahua CP 32 599; MX CP 32599
• Manufacturer Contact: patricia tucker ; 3651 birchwood drive; waukegan, IL 60085 ; 8478874151
• MDR Report Key: 12163500
• MDR Text Key: 261770872
• Report Number: 1423537-2021-00652
• Device Sequence Number: 1
• Product Code: OJG
• UDI-Device Identifier: 10195594098698
• UDI-Public: 10195594098698
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Manufacturer
• Source Type: company representative,health
• Reporter Occupation: Nurse
• Type of Report: Initial
• Report Date: 07/13/2021

1 Device was Involved in the Event

1 Patient was Involved in the Event

• Is this an Adverse Event Report?: No
• Is this a Product Problem Report?: Yes
• Device Operator: Health Professional
• Device Model Number: SNE22SSMS9
• Device Catalogue Number: SNE22SSMS9
• Device Lot Number: 623937
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: 06/15/2021
• Initial Date FDA Received: 07/13/2021
• Was Device Evaluated by Manufacturer?: No
• Date Device Manufactured: 05/05/2021
• Is the Device Single Use?: Yes
• Type of Device Usage: N
• Patient Sequence Number: 1
• Patient Age: 67 YR
• Patient Weight: 88