• Decrease font size
  • Return font size to normal
  • Increase font size
U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES LP MEDLINE; PK,RADIOLOGY-PORTSMOUTH

  • Print
  • Share
  • E-mail
-
Super Search Devices@FDA
510(k) | DeNovo | Registration & Listing | Adverse Events | Recalls | PMA | HDE | Classification | Standards
CFR Title 21 | Radiation-Emitting Products | X-Ray Assembler | Medsun Reports | CLIA | TPLC
 

MEDLINE INDUSTRIES LP MEDLINE; PK,RADIOLOGY-PORTSMOUTH Back to Search Results
Catalog Number DYNJ44087B
Medical Device Problem Codes Crack (1135); Material Integrity Problem (2978)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 01/28/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
It was reported that the syringe was cracking "under standard pressure".The concern is that "this is possibly causing air bubbles to travel into arteries" which could result in a harmful outcome for the patient.Stroke is a risk".It was reported that when the crack was noticed, the device was no longer used.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
Syringe cracking.
 
Search Alerts/Recalls

  New Search  |  Submit an Adverse Event Report

Brand Name
MEDLINE
Common Device Name
PK,RADIOLOGY-PORTSMOUTH
Manufacturer (Section D)
MEDLINE INDUSTRIES LP
three lakes drive
northfield IL 60093
Manufacturer Contact
kelly zampella
three lakes drive
northfield, IL 60093
MDR Report Key24462733
Report Number1423395-2026-00030
Device Sequence Number9403705
Product Code OEZ
UDI-Device Identifier10195327346584
UDI-Public10195327346584
Combination Product (Y/N)N
Initial Reporter StateNH
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) 02/26/2026
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
Device Catalogue NumberDYNJ44087B
Device Lot Number25IBS887
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer02/02/2026
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 01/29/2026
Initial Report FDA Received Date02/26/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured09/26/2025
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
-
-