MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP MEDLINE; PAD,ABDOMINAL,5"X9",STERILE,LF,1/PK

Catalog Number	NON21450
Medical Device Problem Code	Contamination (1120)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	03/25/2026
Type of Reportable Event	Malfunction
Additional Manufacturer Narrative
Contaminant inside abdominal pad.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.
Event or Problem Description
Contaminant inside abdominal pad.
Additional Manufacturer Narrative
Updated h6: type of investigation: 10: testing of actual device.Updated h6: investigation findings: 4242: maintenance of manufacturing machinery.Updated h6: investigation conclusions: 51: cause traced to maintenance.

• Brand Name: MEDLINE
• Common Device Name: PAD,ABDOMINAL,5"X9",STERILE,LF,1/PK
• Manufacturer (Section D): MEDLINE INDUSTRIES, LP; three lakes drive; northfield IL 60093 2753
• Manufacturer Contact: brooke jantzen ; three lakes drive; northfield, IL 60093-2753
• MDR Report Key: 24801610
• Report Number: 1417592-2026-00375
• Device Sequence Number: 10667110
• Product Code: NAB
• UDI-Device Identifier: 10080196690909
• UDI-Public: 10080196690909
• Combination Product (Y/N): N
• Initial Reporter State: ID
• Initial Reporter Country: US
• PMA/510(K) Number: N/A
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Serviced by Third Party (Y/N): Unknown
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Initial Reporter Occupation: Other
• Type of Report: Initial,Followup
• Report Date (Section B): 05/11/2026

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 Number: NON21450
• Device Lot Number: 6052510011
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 03/25/2026
• Supplement Date Received by Manufacturer: 04/15/2026
• Initial Report FDA Received Date: 04/07/2026
• Supplement Report FDA Received Date: 05/11/2026
• 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 Number: 1
• Patient Sex: Unknown