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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP MEDLINE; DBD-TOTAL KNEE CDS

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MEDLINE INDUSTRIES, LP MEDLINE; DBD-TOTAL KNEE CDS Back to Search Results
Catalog Number CDS983297M
Medical Device Problem Code Break (1069)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
It was reported that the syringes broke while injecting local anesthesia in the sterile field.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.
 
Event or Problem Description
It was reported that the syringes broke while injecting local anesthesia in the sterile field.
 
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Brand Name
MEDLINE
Common Device Name
DBD-TOTAL KNEE CDS
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 Key23919746
Report Number1423395-2025-00214
Device Sequence Number21089855
Product Code OJH
UDI-Device Identifier10193489425857
UDI-Public10193489425857
Combination Product (Y/N)N
Initial Reporter StateIL
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) 12/29/2025
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? Yes
Operator of Device Health Professional
Device Catalogue NumberCDS983297M
Was Device Available for Evaluation? No
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 12/03/2025
Initial Report FDA Received Date12/30/2025
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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