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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDLINE INDUSTRIES, LP - SPT MEDLINE; NEURO-ORTHO EXTRAS

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MEDLINE INDUSTRIES, LP - SPT MEDLINE; NEURO-ORTHO EXTRAS Back to Search Results
Catalog Number DYNJ44882O
Medical Device Problem Code Leak/Splash (1354)
Health Effect - Clinical Code No Clinical Signs, Symptoms or Conditions (4582)
Date of Event 04/23/2026
Type of Reportable Event Malfunction
Additional Manufacturer Narrative
It was reported on (b)(6) that the prep scrub was already activated 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 is a reportable event.If additional information becomes available this report will be reopened and reevaluated.
 
Event or Problem Description
It was reported on (b)(6) that the prep scrub was already activated in the pack.
 
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Brand Name
MEDLINE
Common Device Name
NEURO-ORTHO EXTRAS
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 Key25266378
Report Number1423395-2026-00185
Device Sequence Number15742531
Product Code LRO
UDI-Device Identifier10198459213755
UDI-Public10198459213755
Combination Product (Y/N)N
Initial Reporter StateMN
Initial Reporter CountryUS
PMA/510(K) Number
K213481
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
Report Date (Section B) 05/23/2026
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 NumberDYNJ44882O
Device Lot Number25JDA322
Was Device Available for Evaluation? Device Returned to Manufacturer
Date Returned to Manufacturer04/30/2026
Type of Report(Section G)Thirty-Day
Initial Date Received by Manufacturer 04/23/2026
Initial Report FDA Received Date05/23/2026
Was Device Evaluated by Manufacturer? (Y/N) Yes
Date Device Manufactured10/06/2025
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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