MAUDE Adverse Event Report: CENTURION MEDICAL PRODUCTS, LP CIRCLAMP WITH BELL; CLAMP, CIRCUMCISION

Lot Number 2022121401

Device Problems Contamination (1120); Defective Device (2588)

Patient Problem Insufficient Information (4580)

Event Date 02/14/2023

Event Type  malfunction  

Event Description

Several sterile circlamps were opened (both new and reprocessed) and found to have a defects.The sterile items were found with pitting and rust appearing residue upon inspection.The round screw area appeared to be dirty upon opening package.Upon discovery of this issue, the circlamps have all been pulled from areas that use them in our facility.Medline representative was also notified of the finding and pictures were sent to the rep.Alternative products were ordered to be received the following day (2/16/2023).Reference reports: mw5115046, mw5115047.

• Brand Name: CIRCLAMP WITH BELL
• Type of Device: CLAMP, CIRCUMCISION
• Manufacturer (Section D): CENTURION MEDICAL PRODUCTS, LP; williamston MI 48895
• MDR Report Key: 16400884
• MDR Text Key: 309955892
• Report Number: MW5115045
• Device Sequence Number: 1
• Product Code: HFX
• Combination Product (y/n): N
• Reporter Country Code: US
• Number of Events Reported: 1
• Summary Report (Y/N): N
• Report Source: Voluntary
• Reporter Occupation: Risk Manager
• Type of Report: Initial
• Report Date: 02/16/2023

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 Lot Number: 2022121401
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: Yes
• Initial Date Manufacturer Received: Not provided
• Initial Date FDA Received: 02/16/2023
• Patient Sequence Number: 1
• Patient Outcome(s): Other
• Patient Sex: Prefer Not To Disclose
• Patient Ethnicity: Non Hispanic
• Patient Race: White