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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES LP; SYRINGE,EAR/ULCER, 2 OZ, STERILE

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MEDLINE INDUSTRIES LP; SYRINGE,EAR/ULCER, 2 OZ, STERILE Back to Search Results
Catalog Number DYND70280
Medical Device Problem Code Suction Problem (2170)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 05/01/2025
Type of Reportable Event Malfunction
Event or Problem Description
Minimal suction from the bulb syringe.
 
Additional Manufacturer Narrative
It was reported that the "provider noticed a significant difference between the two types of bulb syringes".A new device was used.No inury was noted.In an abundance of caution, this medwatch is being filed.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.In an abundance of caution, and in response to an fda 483 issued for cfn 1417592 on 22-jan-2024, this medwatch is being filed for the reported problem/issue.If additional relevant information becomes available a supplemental medwatch will be filed.
 
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Common Device Name
SYRINGE,EAR/ULCER, 2 OZ, STERILE
Manufacturer (Section D)
MEDLINE INDUSTRIES LP
three lakes drive
northfield IL 60093
Manufacturer Contact
kelly zampella
three lakes drive
northfield, IL 60093
MDR Report Key22203711
Report Number1417592-2025-00292
Device Sequence Number6887766
Product Code KYZ
UDI-Device Identifier10080196035038
UDI-Public10080196035038
Combination Product (Y/N)N
Initial Reporter StateID
Initial Reporter CountryUS
Number of Events Summarized1
Summary Report (Y/N)N
Serviced by Third Party (Y/N)Unknown
Reporter Type Manufacturer
Report Source Health Professional
Initial Reporter Occupation Other
Type of Report Initial
Report Date (Section B) 06/13/2025
1 Device was Involved in the Event
1 Patient was Involved in the Event
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Catalogue NumberDYND70280
Device Lot Number48624090001, 96924110001
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 05/19/2025
Initial Report FDA Received Date06/13/2025
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/01/2024
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Outcome Attributed to Adverse Event Other;
Patient SexUnknown
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