| Brand Name | VISTEC |
| Common Device Name | GAUZE/SPONGE, INTERNAL, X-RAY DETECTABLE |
| Manufacturer (Section D) |
| CARDINAL HEALTH 200, LLC |
| 3651 birchwood drive |
| waukegan IL 60085 |
|
| Manufacturer (Section G) |
| CARDINAL HEALTH |
| 1430 marvin griffin road, po b |
|
| augusta GA 30906 |
|
| Manufacturer Contact |
|
jill
saraiva
|
| 3651 birchwood drive |
| waukegan, IL 60085
|
|
5083163640
|
|
| MDR Report Key | 25536910 |
| Report Number | 1423537-2026-00199 |
| Device Sequence Number | 9771932 |
| Product Code |
GDY
|
| UDI-Device Identifier | 20192253047230 |
| UDI-Public | (01)20192253047230(10)25L066962 |
| Combination Product (Y/N) | N |
| Initial Reporter State | VA |
| Initial Reporter Country | US |
| PMA/510(K) Number | EXEMPT |
| Number of Events Summarized | 1 |
| Summary Report (Y/N) | N |
| Reporter Type |
Manufacturer
|
| Report Source |
Company Representative,Distributor |
| Initial Reporter Occupation |
Other
|
| Type of Report
| Initial,Followup |
| Report Date (Section B) |
06/18/2026 |
| 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 Model Number | 7148 |
| Device Catalogue Number | 7148- |
| Device Lot Number | 25L066962 |
| Was Device Available for Evaluation? |
No
|
| Is the Reporter a Health Professional? |
No
|
| Type of Report(Section G) | Thirty-Day |
| Initial Date Received by Manufacturer | 05/28/2026 |
| Supplement Date Received by Manufacturer | Not provided
|
| Initial Report FDA Received Date | 06/17/2026 |
| Supplement Report FDA Received Date | 06/18/2026
|
| Is the Device Labeled for Single Use? (Y/N) |
Yes
|
Is This a Single-Use Device that was Reprocessed and Reused on a Patient? (Y/N) |
No
|
| Usage of Device |
A
|
| Patient Sequence Number | 1 |
| Patient Sex | Unknown |
|
|