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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP; ESI TRAY

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MEDLINE INDUSTRIES, LP; ESI TRAY Back to Search Results
Catalog Number PAIN2152
Medical Device Problem Code Physical Resistance/Sticking (4012)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Event or Problem Description
It was reported that the stylet was unable to be removed on an 18g spinal needle.The provider had to re-stick the patient using another needle.
 
Additional Manufacturer Narrative
It was reported that the stylet was unable to be removed on an 18g spinal needle.The provider had to re-stick the patient using another needle.It has been determined that the reported event could cause or contribute to serious injury if it were to occur.In an abundance of caution, this medwatch is being filed.If any further relevant information is identified or obtained, a supplemental medwatch will be submitted.
 
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Common Device Name
ESI TRAY
Manufacturer (Section D)
MEDLINE INDUSTRIES, LP
three lakes dr
northfield IL 60093
Manufacturer Contact
gavin-ainsley nadong
three lakes dr
northfield, IL 60093
MDR Report Key22832769
Report Number1417592-2025-00394
Device Sequence Number9431287
Product Code OFT
UDI-Device Identifier10198459065248
UDI-Public10198459065248
Combination Product (Y/N)N
Initial Reporter StateTN
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 Health Care Professional
Type of Report Initial
Report Date (Section B) 08/18/2025
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
Operator of Device Health Professional
Device Catalogue NumberPAIN2152
Device Lot Number25DBF017
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/22/2025
Initial Report FDA Received Date08/18/2025
Was Device Evaluated by Manufacturer? (Y/N) No
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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