| Brand Name | TIDI |
| Common Device Name | DRAPE, SURGICAL, EXEMPT |
| Manufacturer (Section D) |
| TIDI PRODUCTS, LLC |
| 570 enterprise dr |
| neenah WI 54956 |
|
| MDR Report Key | 23802860 |
| Report Number | 23802860 |
| Device Sequence Number | 7686091 |
| Product Code |
PUI
|
| UDI-Device Identifier | 00618125140428 |
| UDI-Public | (01)00618125140428(11)250130(17)300130(10)66444800 |
| Combination Product (Y/N) | N |
| Initial Reporter State | VA |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
User Facility
|
| Initial Reporter Occupation |
Other Health Care Professional
|
| Type of Report
| Initial |
| Report Date (Section B) |
11/19/2025 |
| Report Date (Section F) |
11/19/2025 |
| 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
|
| Operator of Device |
Health Professional
|
| Device Model Number | CFI-655 |
| Device Catalogue Number | CFI-655 |
| Device Lot Number | 66444800 |
| Is the Reporter a Health Professional? |
Yes
|
| Was the Report Sent to FDA? |
Yes
|
| Event Location |
Hospital
|
| Date Report to Manufacturer | 12/15/2025 |
| Initial Date Received by Manufacturer | Not provided |
| Initial Report FDA Received Date | 12/15/2025 |
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
Unknown
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
| Date Report Sent to FDA | 11/19/2025 |
|
|