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

Catalog Number	DYNJ41552J
Medical Device Problem Code	Contamination (1120)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	12/15/2025
Type of Reportable Event	Malfunction
Event or Problem Description
According to the report, on (b)(6) 2025 a "small contaminate" was identified "between the laps", the patient was woken up from general anesthesia while "the set up was torn down and sent back to sterile processing for re-sterilization", and the patient had to have a "2nd general anesthetic" when the procedure was able to be performed "3.5 hours" later.
Additional Manufacturer Narrative
According to the report, on (b)(6) 2025 a "small contaminate" was identified "between the laps", the patient was woken up from general anesthesia while "the set up was torn down and sent back to sterile processing for re-sterilization", and the patient had to have a "2nd general anesthetic" when the procedure was able to be performed "3.5 hours" later.The customer did not report any serious injury, medical intervention, or follow up care related to the reported incident.No additional details are available related to the customer reported issue.Despite multiple good faith efforts to obtain additional information, the customer contact was unable or unwilling to provide further incident details to the manufacturer.No additional information is available.It has been determined that the reported event could cause or contribute to serious injury if it were to occur again.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.

• Brand Name: MEDLINE
• Common Device Name: DBD-MV TOTAL KNEE-LF
• Manufacturer (Section D): MEDLINE INDUSTRIES, LP; three lakes drive; northfield IL 60093
• Manufacturer Contact: danielle pohlman ; three lakes drive; northfield, IL 60093
• MDR Report Key: 24039838
• Report Number: 1423395-2026-00003
• Device Sequence Number: 18760013
• Product Code: LRO
• UDI-Device Identifier: 10195327548759
• UDI-Public: 10195327548759
• Combination Product (Y/N): N
• Initial Reporter State: ID
• Initial Reporter Country: US
• PMA/510(K) Number: K213481
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Health Professional
• Initial Reporter Occupation: Administrator/Supervisor
• Type of Report: Initial
• Report Date (Section B): 01/12/2026

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 Number: DYNJ41552J
• Device Lot Number: 25CMB683
• Was Device Available for Evaluation?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 12/15/2025
• Initial Report FDA Received Date: 01/12/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 03/06/2025
• 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
• Outcome Attributed to Adverse Event: Other
• Patient Age: 83 YR
• Patient Sex: Female