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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP MEDLINE; BAG,LEG,TWIST-VALVE,STRAPS,LARGE,32OZ

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MEDLINE INDUSTRIES, LP MEDLINE; BAG,LEG,TWIST-VALVE,STRAPS,LARGE,32OZ Back to Search Results
Catalog Number DYND12578H
Medical Device Problem Code Leak/Splash (1354)
Health Effect - Clinical Code Insufficient Information (4580)
Date of Event 03/31/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
Bag was leaking, threw away.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
Customer reported, "bag was leaking, threw away.".
 
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Brand Name
MEDLINE
Common Device Name
BAG,LEG,TWIST-VALVE,STRAPS,LARGE,32OZ
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 Key25009168
Report Number1417592-2026-00632
Device Sequence Number15987547
Product Code KNX
UDI-Device Identifier10080196990320
UDI-Public10080196990320
Combination Product (Y/N)N
Initial Reporter StateNJ
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 Nurse
Type of Report Initial
Report Date (Section B) 04/27/2026
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
Operator of Device Lay User/Patient
Device Catalogue NumberDYND12578H
Device Lot Number96925110001
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 03/31/2026
Initial Report FDA Received Date04/27/2026
Was Device Evaluated by Manufacturer? (Y/N) No
Date Device Manufactured11/01/2025
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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