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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP - SPT MEDLINE; KIT TOTAL JOINT

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MEDLINE INDUSTRIES, LP - SPT MEDLINE; KIT TOTAL JOINT Back to Search Results
Catalog Number DYNJ908867
Medical Device Problem Code Leak/Splash (1354)
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
It was reported on 03/25 that the chloraprep preactivated in the pack.There were no reports of death, serious injury, medical intervention, or follow up care.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
It was reported on 03/25 that the chloraprep preactivated in the pack.
 
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Brand Name
MEDLINE
Common Device Name
KIT TOTAL JOINT
Manufacturer (Section D)
MEDLINE INDUSTRIES, LP - SPT
1170 s northpoint boulevard
waukegan IL 60085 6757
Manufacturer Contact
nithla mathivanan
three lakes drive
northfield, IL 60093-2753
MDR Report Key24958485
Report Number1423395-2026-00101
Device Sequence Number10084776
Product Code OJH
UDI-Device Identifier10195327197094
UDI-Public10195327197094
Combination Product (Y/N)N
Initial Reporter StateMA
Initial Reporter CountryUS
PMA/510(K) Number
N/A
Number of Events Summarized1
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) 05/21/2026
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 NumberDYNJ908867
Device Lot Number25LBG532
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 Manufacturer04/22/2026
Initial Report FDA Received Date04/22/2026
Supplement Report FDA Received Date05/21/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured12/09/2025
Is This a Single-Use Device that was
Reprocessed and Reused on a Patient? (Y/N)
No
Usage of Device Unknown
Patient Sequence Number1
Patient SexUnknown
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