MAUDE Adverse Event Report: Medline Industries, LP MEDLINE; GLOVE,SURG,SIGNATURE LTX,ESS,LTX,PF,8

Catalog Number	MSG5980
Medical Device Problem Code	Material Discolored (1170)
Health Effect - Clinical Code	No Clinical Signs, Symptoms or Conditions (4582)
Date of Event	06/25/2024
Type of Reportable Event	Malfunction
Event or Problem Description
It was reported that: "several instances of gloves ripping during procedures.Coloring appears off as well.Gloves sticking to packaging.".
Additional Manufacturer Narrative
The customer reported gloves ripping during procedures, coloring appears off, and gloves sticking to packaging.Inspection reports were reviewed, the lot passed inspection for all physical properties per astm standards, and a historical complaint query for the last 24 months did not identify a trend for the reported issue.The finished device alleged failure investigation was returned by the manufacturer; no potential causes were identified, no sample was returned for the investigation, and the issue is not confirmed.Based on the investigation results, no further actions are being taken at this time.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.This medical device report (mdr) is being submitted as part of retrospective review activities, which include review of historical data in accordance with regulations at 21 cfr part 803.The information included in this mdr reflects the information reasonably known to the manufacturer at the time of this retrospective review and submission.

• Brand Name: MEDLINE
• Common Device Name: GLOVE,SURG,SIGNATURE LTX,ESS,LTX,PF,8
• Manufacturer (Section D): Medline Industries, LP; three lakes drive; northfield IL 60093 -275
• Manufacturer Contact: ankitha komirishetty ; three lakes drive; northfield, IL 60093--275
• MDR Report Key: 50713410
• Report Number: 1417592-2026-35644
• Device Sequence Number: 13408210
• Product Code: KGO
• UDI-Device Identifier: 30888277629763
• UDI-Public: 30888277629763
• Combination Product (Y/N): N
• Initial Reporter State: ID
• Initial Reporter Country: US
• PMA/510(K) Number: K183536
• Number of Events Summarized: 1
• Summary Report (Y/N): N
• Reporter Type: Manufacturer
• Report Source: Company Representative
• Type of Report: Initial
• Report Date (Section B): 09/05/2026

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: MSG5980
• Device Lot Number: CC68595680
• Was Device Available for Evaluation?: Yes
• Is the Reporter a Health Professional?: No
• Was the Report Sent to FDA?: No
• Type of Report(Section G): Thirty-Day
• Initial Date Received by Manufacturer: 06/25/2024
• Initial Report FDA Received Date: 09/10/2026
• Was Device Evaluated by Manufacturer? (Y/N): No
• 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
• Patient Sequence Number: 1
• Patient Sex: Unknown