MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP MEDLINE; ENT PACK

Catalog Number	DYNJ86010A
Medical Device Problem Codes	Material Separation (1562); Material Integrity Problem (2978)
Health Effect - Clinical Code	Foreign Body In Patient (2687)
Date of Event	03/04/2026
Type of Reportable Event	Malfunction
Event or Problem Description
According to the customer contact, on (b)(6) 2026, the 4x4 gauze x-ray product has fibers or strands coming off and are having to be pulled out of the wound.
Additional Manufacturer Narrative
According to the customer contact, on (b)(6)2026, the 4x4 gauze x-ray product has fibers or strands coming off and are having to be pulled out of the wound.The facility reports no medical intervention or follow-up care was needed for the individual.No additional information at this time.It has been determined that the reported event could cause or contribute to serious injury if it were to occur.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: ENT PACK
• Manufacturer (Section D): MEDLINE INDUSTRIES, LP; three lakes drive; northfield IL 60093 2753
• Manufacturer Contact: alyssa reasner ; three lakes drive; northfield, IL 60093-2753
• MDR Report Key: 24745394
• Report Number: 1423395-2026-00060
• Device Sequence Number: 8780459
• Product Code: OGR
• UDI-Device Identifier: 10198459133695
• UDI-Public: 10198459133695
• Combination Product (Y/N): N
• Initial Reporter State: MI
• Initial Reporter Country: US
• 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: Nurse
• Type of Report: Initial
• Report Date (Section B): 03/31/2026

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: DYNJ86010A
• Device Lot Number: 25LDB327
• Was Device Available for Evaluation?: No
• Is the Reporter a Health Professional?: Yes
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 03/05/2026
• Initial Report FDA Received Date: 03/31/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• Date Device Manufactured: 12/18/2025
• 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 Sex: Unknown