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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES LP; BURKARD PROCEDURE TRAY

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MEDLINE INDUSTRIES LP; BURKARD PROCEDURE TRAY Back to Search Results
Catalog Number DYNJRA1250B
Medical Device Problem Code Material Too Rigid or Stiff (1544)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 07/25/2025
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
The customer reported "stiffer" syringes.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 (b)(6) 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.
 
Event or Problem Description
Stiff syringe.
 
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Common Device Name
BURKARD PROCEDURE TRAY
Manufacturer (Section D)
MEDLINE INDUSTRIES LP
three lakes drive
northfield IL 60093
Manufacturer Contact
kelly zampella
three lakes drive
northfield, IL 60093
MDR Report Key22849176
Report Number1417592-2025-00398
Device Sequence Number4461874
Product Code LRO
UDI-Device Identifier10195327045449
UDI-Public10195327045449
Combination Product (Y/N)N
Initial Reporter StateCA
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) 08/20/2025
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 NumberDYNJRA1250B
Device Lot Number25CMC159
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 07/25/2025
Initial Report FDA Received Date08/20/2025
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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